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Individual
SUNDARA C NALLA
Active
Individual
SUNDARA C NALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32815
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080120227
RR MEDICARE
MN
01
—
0D930NA
BCBS MPIN
MN
01
—
115527
UCARE
FM
05
—
1967802
—
IA
05
—
950797300
—
MN
Enumeration date
10/02/2006
Last updated
11/30/2021
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