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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

SUMANTH MULAMALLA, MD
15900 W 101ST AVE
DYER, IN46311-3065
 Phone: 219-365-6333
 Fax: 219-365-8291
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SUMANTH MULAMALLA · (Male)

NPI # 1003019647
Status Active
Credentials MD
Entity Individual
Enumeration date 06/11/2007
Last updated 04/21/2016 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01065980A
  • IN Medicaid 201121060A
  • IL Other F400289465 IL MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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