Individual
DR. ROJA R MULAMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
444 W BOURNE CIR STE 200, FARMINGTON, UT 84025
(801) 776-0174
(801) 825-3904
Mailing address
444 W BOURNE CIR STE 200, FARMINGTON, UT 84025-3657
(801) 397-3000
(801) 397-0455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8332919-1205
UT
207R00000X
Internal Medicine Physician
LL1646
NV
207RC0000X
Cardiovascular Disease Physician
Primary
8332919-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100500484 GROUP
—
NV
Enumeration date
03/19/2007
Last updated
06/13/2019
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