Provider Demographics
NPI:1912943846
Name:ATURALIYA, UPALI P (MD)
Entity Type:Individual
Prefix:
First Name:UPALI
Middle Name:P
Last Name:ATURALIYA
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 1:5007 MATTERHORN DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3812
Mailing Address - Country:US
Mailing Address - Phone:218-720-3553
Mailing Address - Fax:218-786-9375
Practice Address - Street 1:5007 MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3812
Practice Address - Country:US
Practice Address - Phone:218-720-3553
Practice Address - Fax:218-786-9375
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN21836207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN430883200Medicaid
180000996Medicare PIN
MN180000996Medicare ID - Type Unspecified
MN430883200Medicaid