Malladi, Madhusudan R
Malladi, Madhusudan R is an individual health care provider with primary practice located at 1036 W Stephenson St , Freeport IL 61032-4865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Malladi, Madhusudan R can be contacted via phone (815) 599-6000.Contact Information
Primary practice address
1036 W Stephenson St
Freeport IL 61032-4865
Phone: (815) 599-6000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036088380 | Illinois |
Profile Details
| NPI number | 1376515064 |
|---|---|
| LBN Legal business name | Malladi, Madhusudan R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Oct 23rd, 2017 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376515064 | NPPES |
| Illinois | MEDICAID | 036088380 |
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