Individual
VIVEK MALLADI
Active
Individual
VIVEK MALLADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125054286
IL
207L00000X
Anesthesiology Physician
Primary
47505
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831389
—
AZ
01
—
P01306466
MEDICARE RR
AZ
Enumeration date
06/21/2010
Last updated
03/07/2023
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