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Individual
DR. MALLIKARJUNA NANDYALA
Active
Individual
DR. MALLIKARJUNA NANDYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME70271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110244550
RAILROAD MEDICARE
FL
01
—
113934
AMERIGROUP
FL
01
—
139275BJ
PREFERRED CARE
FL
01
—
169930
STAYWELL
FL
01
—
243309
AVMED
FL
05
—
250560600
—
FL
01
—
2509053
AETNA
FL
01
—
2513301
GHI
FL
01
—
31236
BLUE CROSS BLUE SHIELD
FL
01
—
ME0070271
MEDICAL STATE LICENSE
FL
Enumeration date
02/13/2006
Last updated
10/17/2013
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