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Individual

DR. SURYA K NALLARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
417 N HALLECK ST, DEMOTTE, IN 46310-9419
(219) 987-6010
(219) 987-4546
Mailing address
1608 LINCOLNWAY, STE G, VALPARAISO, IN 46383-5852
(219) 987-6010
(219) 987-4546

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01037891
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100143080A
IN
Enumeration date
09/23/2005
Last updated
03/16/2017
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