Doctor Name: | DR. SUNIL KUMAR WALIA |
NPI Number: | 1194986497 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD28322 |
Business Practice Address: | 82911 Beach Access Rd Umatilla, OR - 978829419 |
Business Phone Number: | 5419226014 |
Business Fax Number: | 5419226008 |
Mailing Address: | 82911 Beach Access Rd, UMATILLA |
State: | OR |
Postal Code: | 978829419 |
Phone Number: | 5419226014 |
Fax Number: | 5419226008 |
NPI Enumeration Date: | 06/19/2008 |
NPI Last Update Date: | 06/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD28322 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |