Individual
DR. LALITHA VALLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2316 SOUTH ST, LAFAYETTE, IN 47904-2971
(765) 742-1567
(765) 742-2750
Mailing address
2316 SOUTH ST, LAFAYETTE, IN 47904-2971
(765) 742-1567
(765) 742-2750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01053607A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000345300
ANTHEM
—
01
—
11330984
CAQH
—
05
—
200496230A
—
IN
Enumeration date
11/10/2005
Last updated
01/31/2014
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