Most Relevant Information
Provider Data
| NPI Number: | 1003019647 |
| Provider Name: | SUMANTH MULAMALLA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207RN0300X |
| Specialty: | Internal Medicine |
| License Number: | 01065980A |
Most Important Dates
| Enumeration Date: | 06/11/2007 |
| Last Updated: | 04/21/2016 |
Provider Practice Location
15900 W 101ST AVE
DYER
IN
463113065
Practice Location Phone/Fax
| Phone: | 2193656333 |
| Fax: | 2193658291 |
Provider Mailing Location
210 S DESPLAINES ST
CHICAGO
IL
606615500
Provider Mailing Phone/Fax
| Phone: | 3126542700 |
| Fax: | 3126549930 |
Suggested EMR
Nephrology EMR