Individual
HEMANTHA NAVEEN WALALIYADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1448 E CENTER ST STE E, POCATELLO, ID 83201-4132
(208) 241-1300
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5771930
ID
Other
Enumeration date
03/28/2022
Last updated
12/16/2025
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