Provider Demographics
NPI:1851380125
Name:NAGALA, VANI (MD)
Entity Type:Individual
Prefix:DR
First Name:VANI
Middle Name:
Last Name:NAGALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S 7TH ST
Mailing Address - Street 2:PO BOX 50
Mailing Address - City:OAKES
Mailing Address - State:ND
Mailing Address - Zip Code:58474-2024
Mailing Address - Country:US
Mailing Address - Phone:701-742-3267
Mailing Address - Fax:701-742-3201
Practice Address - Street 1:420 S 7TH ST
Practice Address - Street 2:
Practice Address - City:OAKES
Practice Address - State:ND
Practice Address - Zip Code:58474-2024
Practice Address - Country:US
Practice Address - Phone:701-742-3267
Practice Address - Fax:701-742-3201
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4771207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND18149OtherBLUE SHIELD
ND25946OtherBLUE SHIELD
ND14627Medicaid
ND18147OtherBLUE SHIELD
ND18148OtherBLUE SHIELD
NDCF8850OtherRAILROAD MEDICARE
ND110189980OtherRAILROAD MEDICARE
ND18144OtherBLUE SHIELD
ND18145OtherBLUE SHIELD
ND18146OtherBLUE SHIELD
ND25946OtherBLUE SHIELD
NDCF8850OtherRAILROAD MEDICARE
NDN18144Medicare Oscar/Certification
ND18147OtherBLUE SHIELD
NDCF8850Medicare PIN