NPI 1497747703

Ananda Walaliyadda, MD

Practitioner Specialist Pocatello, ID

Practice location

Address: 1448 E Center St Suite E, Pocatello, ID 83201-4132
Phone: (208) 234-1300
Fax: (208) 234-1333

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence M8731 (ID)

Other Specialist providers in Idaho →

Registry record

NPI: 1497747703
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Aug 2005
Record last updated: 29 Jun 2022

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.