Provider Demographics
NPI:1801384250
Name:DALAI, CAMELLIA (MD)
Entity type:Individual
Prefix:
First Name:CAMELLIA
Middle Name:
Last Name:DALAI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 OAKWOOD HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-7727
Mailing Address - Country:US
Mailing Address - Phone:715-552-7303
Mailing Address - Fax:715-552-7355
Practice Address - Street 1:4109 OAKWOOD HILLS PKWY
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-7727
Practice Address - Country:US
Practice Address - Phone:715-552-7303
Practice Address - Fax:715-552-7355
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI83734-20207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology