Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ANANDA WALALIYADDA, M.D.
ActiveSpecialist · POCATELLO, ID
Registration Details
- NPI Number
- 1497747703
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 22, 2005 (20.694803917944 yrs)
- Last Updated
- Jun 29, 2022
- License
-
M8731 (ID)
Practice Information
- Address
-
1448 E CENTER STSUITE EPOCATELLO, ID, 832014132Browse ID providers · Browse ZIP 83201
- Phone
- 2082341300
- Fax
- 2082341333
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in POCATELLO, ID
| Name | Credential | NPI |
|---|---|---|
| JOHN LACKEY | MD | 1063456648 |
| MR. DOUGLAS P NORMAN | M.D. | 1568499226 |
| JAMIE KAE COBBLEY | OTR/L | 1033396049 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.