Basic Information
| Provider Information | |||||||||
| NPI: | 1457911042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHULIPALLI | ||||||||
| FirstName: | ANITA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2490 EASTSHORE PL UNIT C305 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895090019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757729737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2484 RIVER RD | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974042042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412227600 | ||||||||
| FaxNumber: | 5412227618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2019 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD209439 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.