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Organization

MITTAPALLI OBGYN PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAJA MITTAPALLI MD (OWNER)
(330) 206-9752
Entity
Organization

Contact information

Practice address
845 E. B STREET, SAN LUIS, AZ 85349
(928) 627-5678
(928) 627-5677
Mailing address
PO BOX 8430, SAN LUIS, AZ 85349-6828
(928) 627-5678
(928) 627-5677

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
36264
AZ

Other

Enumeration date
11/14/2013
Last updated
07/14/2014
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