Individual
MALATI PEMMARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Mailing address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34973
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098378100
—
MN
Enumeration date
12/19/2006
Last updated
09/01/2011
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