Provider Demographics
NPI:1053541771
Name:AVUTU, HIMA BINDU REDDY (MD)
Entity type:Individual
Prefix:
First Name:HIMA BINDU
Middle Name:REDDY
Last Name:AVUTU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WELLWATER AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9964
Mailing Address - Country:US
Mailing Address - Phone:614-353-3191
Mailing Address - Fax:
Practice Address - Street 1:102 WELLWATER AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9964
Practice Address - Country:US
Practice Address - Phone:614-353-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195486390200000X
NC2019-022842085R0202X
GA719422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2019-02284OtherMEDICAL LICENSE