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General NPI Number Information
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NPI Number | 1205099330
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Entity Type | Organization
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Legal Business Name | ANIL CHOUDARY NALLURI MD INC
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 5500 MARKET ST STE 128
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City | YOUNGSTOWN
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State | OH
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Zip | 44512
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Country | US
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Telephone | 330-783-1147
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Fax | 330-783-3238
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Provider Business Mailing Address
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Address Line | 5500 MARKET ST STE 128
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City | YOUNGSTOWN
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State | OH
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Zip | 44512
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Country | US
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Telephone | 330-783-1147
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Fax | 330-783-3238
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANIL CHOUDARY NALLURI
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Credential | MD
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Telephone | 330-783-1147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35040657
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License Number State | OH
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