Healthcare Provider Details

I. General information

NPI: 1316574312
Provider Name (Legal Business Name): HINDUJA NALLAMALA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N CAPITOL AVE
INDIANAPOLIS IN
46202-1218
US

IV. Provider business mailing address

1800 N CAPITOL AVE
INDIANAPOLIS IN
46202-1218
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-0700
  • Fax:
Mailing address:
  • Phone: 317-274-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number81089
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number02009020A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: