NPI 1003019647

Sumanth Mulamalla, MD

Practitioner Nephrology Physician Dyer, IN

Practice location

Address: 15900 W 101st Ave, Dyer, IN 46311-3065
Phone: (219) 365-6333
Fax: (219) 365-8291
Mailing address: 210 S Desplaines St, Chicago, IL 60661-5500

Registered specialties

Nephrology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207RN0300X Licence 01065980A (IN)

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Registry record

NPI: 1003019647
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jun 2007
Record last updated: 21 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.