Individual
MALATI V PAMULAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1230 E. MAIN STREET, MANKATO CLINIC @ MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
(507) 231-6376
Mailing address
PO BOX 8674 1230 E. MAIN STREET, MANKATO CLINIC, LTD, MANKATO, MN 56002-8674
(507) 625-1811
(507) 231-6376
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
31199
IA
207Q00000X
Family Medicine Physician
Primary
49206
MN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
49206
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111435
—
IA
Enumeration date
08/19/2006
Last updated
07/15/2020
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