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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972516136 NPPES
Illinois MEDICAID 036053208

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