Individual
BALARAM PULIGANDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8276
(503) 494-2025
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8276
(503) 494-2025
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
G49195
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD203370
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G491950
—
CA
Enumeration date
11/01/2006
Last updated
04/06/2021
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