Provider Demographics
NPI:1720050222
Name:NARULA, AMRIT PAL (MD)
Entity Type:Individual
Prefix:
First Name:AMRIT
Middle Name:PAL
Last Name:NARULA
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 1:82 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3869
Mailing Address - Country:US
Mailing Address - Phone:570-622-5455
Mailing Address - Fax:570-622-5493
Practice Address - Street 1:48 TUNNEL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3875
Practice Address - Country:US
Practice Address - Phone:570-622-5555
Practice Address - Fax:570-622-6047
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035561E207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000169564OtherBLUE SHIELD
PA110031031OtherRAILROAD MECICARE PBA
PA116993900OtherFEDERAL EMPLOYEES COMP
PA50047346OtherCAPITAL BLUE CROSS
PA0473231OtherUS HEALTHCARE
PA09968130OtherKEYSTONE SPECIALIST
PA20075OtherGEISINGER HEALTH PLAN
PA0010734870001Medicaid
PA01682001OtherKEYSTONE
PA020301000OtherFEDERAL BLACK LUNG
PA116993900OtherFEDERAL EMPLOYEES COMP
B40569Medicare UPIN