Individual
DR. MALATESHA GANGAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4300 E FLAMINGO AVE, NAMPA, ID 83687-3138
(208) 205-1000
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
237566
MA
207R00000X
Internal Medicine Physician
Primary
M-11395
ID
Other
Enumeration date
01/28/2009
Last updated
11/17/2025
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