Basic Information
| Provider Information | |||||||||
| NPI: | 1336138601 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAGALA | ||||||||
| FirstName: | RUP | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 SOUTH 7TH ST | ||||||||
| Address2: | PO BOX 50 | ||||||||
| City: | OAKES | ||||||||
| State: | ND | ||||||||
| PostalCode: | 584740050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7017423267 | ||||||||
| FaxNumber: | 7017423201 | ||||||||
| Practice Location | |||||||||
| Address1: | 420 S 7TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKES | ||||||||
| State: | ND | ||||||||
| PostalCode: | 584742024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7017423267 | ||||||||
| FaxNumber: | 7017423201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 12/06/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 3838 | ND | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 25961 | 01 | ND | BLUE SHIELD | OTHER | 12765 | 05 | ND | MEDICAID | 18151 | 01 | ND | BLUE SHIELD | OTHER | 18154 | 01 | ND | BLUE SHIELD | OTHER | 25267 | 01 | BLUE SHIELD | OTHER | 28578 | 01 | ND | BLUE SHIELD | OTHER | 18152 | 01 | ND | BLUE SHIELD | OTHER | 18155 | 01 | ND | BLUE SHIELD | OTHER | 18156 | 01 | ND | BLUE SHIELD | OTHER | DD1370 | 01 | ND | RAILROAD MEDICARE | OTHER | 080027931 | 01 | ND | RAILROAD MEDICARE | OTHER | 13516 | 05 | ND | MEDICAID | CF8850 | 01 | ND | RAILROAD MEDICARE | OTHER | P00210261 | 01 | ND | RAILROAD MEDICARE | OTHER |