Individual
MR. RANGA R THALLURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E STATE ST, ALLIANCE, OH 44601-4936
(330) 596-7650
(330) 596-7657
Mailing address
1218 W STATE ST, ALLIANCE, OH 44601-4626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.062816
OH
2084P0800X
Psychiatry Physician
Primary
35-062816
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000152660
BLUE CROSS
OH
01
—
000000159904
BLUE CROSS
OH
05
—
0987106
—
OH
01
—
104678000
MAGELLAN
OH
01
—
298948105-017
MEDICAL MUTUAL
OH
Enumeration date
08/17/2006
Last updated
12/31/2015
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