Healthcare Provider Details

I. General information

NPI: 1033472337
Provider Name (Legal Business Name): SHUMAL MALEPATI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 NW 11TH ST STE M106
HERMISTON OR
97838-6941
US

IV. Provider business mailing address

620 NW 11TH ST STE M106
HERMISTON OR
97838-6941
US

V. Phone/Fax

Practice location:
  • Phone: 541-667-3801
  • Fax: 541-667-3802
Mailing address:
  • Phone: 541-667-3801
  • Fax: 541-667-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD228351
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60344914
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: