1972767655 NPI number — MRS. SMRUTI SHAILESH NALAWADI M.D

Table of content: MRS. SMRUTI SHAILESH NALAWADI M.D (NPI 1972767655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972767655 NPI number — MRS. SMRUTI SHAILESH NALAWADI M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NALAWADI
Provider First Name:
SMRUTI
Provider Middle Name:
SHAILESH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATIL
Provider Other First Name:
SMRUTI
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1972767655
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18181 BUTTERFIELD BLVD # 180A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORGAN HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95037-8108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-356-8400
Provider Business Mailing Address Fax Number:
855-824-6677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18181 BUTTERFIELD BLVD # 180A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGAN HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95037-8108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-356-8400
Provider Business Practice Location Address Fax Number:
855-824-6677
Provider Enumeration Date:
07/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A 104130 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)