Provider Demographics
NPI:1942513155
Name:NITTALA, MURALI (MD)
Entity Type:Individual
Prefix:
First Name:MURALI
Middle Name:
Last Name:NITTALA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MS 2005
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-2937
Mailing Address - Country:US
Mailing Address - Phone:913-588-6124
Mailing Address - Fax:913-588-7540
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MS 2005
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-2937
Practice Address - Country:US
Practice Address - Phone:913-588-6124
Practice Address - Fax:913-588-7540
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS94-07569208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery