Ranmali Kalyani Walaliyadda, PAC

NPI #1801976923 in Pocatello, Idaho

Provider Information

NPI Number: 1801976923
Entity Type: Individual
Name: Ranmali Kalyani Walaliyadda, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Oct 16, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1448 E CENTER ST
Address 2: SUITE E
City: Pocatello
State: Idaho
ZIP Code: 83201-4132
Phone: (208) 234-1300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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