Individual
MR. HIMANSHU RAJ ULLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5882 S HOSPITAL DR STE 1, GLOBE, AZ 85501-9455
(928) 793-3747
(928) 793-3745
Mailing address
1630 E ASH ST, GLOBE, AZ 85501-1430
(928) 812-3198
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
AZ
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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