Provider Demographics
NPI:1518060854
Name:MURALIDHAR, PALLAKI (MD,FACP)
Entity Type:Individual
Prefix:DR
First Name:PALLAKI
Middle Name:
Last Name:MURALIDHAR
Suffix:
Gender:M
Credentials:MD,FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 EAST BLD
Mailing Address - Street 2:GERIATRICS,CLEVELAND VA MEDICAL CENTER
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-421-3027
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:GERIATRICS,CLEVELAND VA MEDICAL CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-421-3027
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.064684207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine