Provider Demographics
NPI:1194986497
Name:WALIA, SUNIL KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:KUMAR
Last Name:WALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:82911 BEACH ACCESS RD
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:OR
Mailing Address - Zip Code:97882-9419
Mailing Address - Country:US
Mailing Address - Phone:541-922-6014
Mailing Address - Fax:541-922-6008
Practice Address - Street 1:82911 BEACH ACCESS RD
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:OR
Practice Address - Zip Code:97882-9419
Practice Address - Country:US
Practice Address - Phone:541-922-6014
Practice Address - Fax:541-922-6008
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD28322208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice