HEMANTHA NAVEEN WALALIYADDA

IDAHO FALLS, ID
NPI1295485746
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: ID  390200000X)
Enumeration Date2022-03-28
Last Update Date2022-03-28
Business Address
HEMANTHA NAVEEN WALALIYADDA MD
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 208-529-6111
Mailing Address
HEMANTHA NAVEEN WALALIYADDA MD
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 208-529-6111
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