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General NPI Number Information
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NPI Number | 1982756565
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Entity Type | Individual
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Provider Name | SHIYAMA MUDALI M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-320-2695
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Fax | 302-320-4618
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Provider Business Mailing Address
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Address Line | 4755 OGLETOWN STANTON RD
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-320-2695
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Fax | 302-320-4618
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 35.120826
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | C1-0027278
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME108420
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | C1-0027278
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License Number State | DE
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