| Surya K Nallari Md | |
|
404 10th St Sw Demotte IN 46310-9298 | |
| (219) 987-6010 | |
| Not Available |
| Full Name | Surya K Nallari Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 404 10th St Sw, Demotte, Indiana |
| Authorized Official Name and Position | Surya K Nallari (PRESIDENT) |
| Authorized Official Contact | 2199876010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Surya K Nallari Md 404 10th St Sw Demotte IN 46310-9298 Ph: (219) 987-6010 | Surya K Nallari Md 404 10th St Sw Demotte IN 46310-9298 Ph: (219) 987-6010 |
| NPI Number | 1760792881 |
|---|---|
| Provider Enumeration Date | 10/08/2010 |
| Last Update Date | 10/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760792881 | NPI | - | NPPES |
| 201009800A | Medicaid | IN | |
| 201009800B | Medicaid | IN | |
| 000000209586 | Other | IN | ANTHEM |
| 201009800C | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01037891A (Indiana) | Primary |
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