Provider Demographics
NPI:1669660379
Name:NALLURI, MURALI K (MD)
Entity Type:Individual
Prefix:DR
First Name:MURALI
Middle Name:K
Last Name:NALLURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 W 5TH AVE STE 501
Practice Address - Street 2:CAPITAL CITY GASTROENTEROLOGY, PC
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2967
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:509-755-6580
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005003970207RG0100X
ALMD32871207RG0100X
WAMD60513782207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ323615Medicaid
AZ323615Medicaid