Bala Koteswara Rao Davuluri

Psychiatry & Neurology, Neurology in Kokomo, IN. Individual provider (NPI-1).

NPI number1407010754

StatusActive

Last updated in NPPESApr 15, 2022

Details

NPI: 1407010754
Entity type: Individual (NPI-1)
Name: Bala Koteswara Rao Davuluri
Sex: Male
Sole proprietor: No
Enumeration date: Jul 16, 2008
Certification date: Mar 4, 2022
Last updated: Apr 15, 2022

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2084N0400X	Psychiatry & Neurology, Neurology	01084760A	IN	Yes
2084N0400X	Psychiatry & Neurology, Neurology	52575	MN
2084N0400X	Psychiatry & Neurology, Neurology	62281-020	WI
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Other names

N/A N/A N/A (Other Name)

Practice location

2354 West Boulvard
Kokomo, IN 46902-6069

Phone 765-457-4800

Mailing address

Po Box 844658
Dallas, TX 75284-4658

Phone 254-724-2111

Other practice locations

1821 S Webster Ave
Green Bay, WI 54301-2253

Phone 920-496-4700

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Phone 254-724-1111

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Neurology Physician providers in Kokomo, IN

All 12 Neurology Physician providers in Kokomo · All 2,349 providers in Kokomo

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