Dr. Sumanth Mulamalla
Nephrologist
15900 W 101st Ave
Dyer
, Indiana 46311-3065
Dr. Sumanth Mulamalla
Nephrologist
15900 W 101st Ave
Dyer
, Indiana 46311-3065
(312) 654-9930
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Dr. Sumanth Mulamalla
- 210 S Desplaines St
- Chicago, IL
- Zip : 60661-5500
- Fax : (312) 654-9930
- Phone : (312) 654-2700
Second Address
- Dr. Sumanth Mulamalla
- 15900 W 101st Ave
- Dyer, IN
- Zip : 46311-3065
- Fax : (219) 365-8291
- Phone : (219) 365-6333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | 01065980A | IN |
National Provider Identifier
| NPI | 1003019647 |
|---|---|
| Provider Name | Dr. Sumanth Mulamalla |
| First Address | Chicago, IL 60661-5500 |
| Second Address | Dyer, IN 46311-3065 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2007 |
| Last Update Date | 21/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 201121060A | (05) | IN |
| F400289465 | IL MEDICARE PTAN (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.