Individual
DR. MADHAVA T PALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., P.A.
Contact information
Practice address
1520 SLATE CREEK RD STE 205, GRUNDY, VA 24614-6975
(276) 935-1640
(606) 218-4697
Mailing address
2316 PATRINOSTRO RD, PLANT CITY, FL 33565-7228
(888) 246-0313
(888) 247-1186
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME42506
FL
207RC0000X
Cardiovascular Disease Physician
Primary
0101263918
VA
207RC0000X
Cardiovascular Disease Physician
51263
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067609800
—
FL
Enumeration date
08/03/2006
Last updated
07/07/2023
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