Vallala, Madhusudan
Vallala, Madhusudan is an individual health care provider with primary practice located at 2 Saint Anthonys Way Suite 205, Alton IL 62002-4569. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Vallala, Madhusudan can be contacted via phone (618) 462-2222.Contact Information
Primary practice address
2 Saint Anthonys Way Suite 205
Alton IL 62002-4569
Phone: (618) 462-2222
Fax: (618) 463-5004
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036053208 | Illinois |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036053208 | Illinois |
Profile Details
| NPI number | 1972516136 |
|---|---|
| LBN Legal business name | Vallala, Madhusudan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2006 |
| Last updated | Aug 18th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972516136 | NPPES |
| Illinois | MEDICAID | 036053208 |
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