Healthcare Provider Details

I. General information

NPI: 1669660379
Provider Name (Legal Business Name): MURALI K NALLURI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S PIONEER WAY
MOSES LAKE WA
98837-4613
US

IV. Provider business mailing address

660 S COOLIDGE ST
MOSES LAKE WA
98837-1872
US

V. Phone/Fax

Practice location:
  • Phone: 509-793-9784
  • Fax: 509-764-3280
Mailing address:
  • Phone: 509-793-9715
  • Fax: 509-764-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD60513782
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2005003970
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD32871
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: