Provider Demographics
NPI:1881649879
Name:NALLARI, ANITHA S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITHA
Middle Name:S
Last Name:NALLARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 POLARIS PKWY
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7989
Mailing Address - Country:US
Mailing Address - Phone:614-846-0044
Mailing Address - Fax:614-846-3464
Practice Address - Street 1:340 E TOWN ST
Practice Address - Street 2:SUITE 8-200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4600
Practice Address - Country:US
Practice Address - Phone:614-846-0044
Practice Address - Fax:614-846-3464
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.124169207R00000X, 207RH0003X
IL036108584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108584Medicaid
ILK01452Medicare ID - Type UnspecifiedDUPAGE
ILH96287Medicare UPIN