Basic Information
| Provider Information | |||||||||
| NPI: | 1720050222 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NARULA | ||||||||
| FirstName: | AMRIT | ||||||||
| MiddleName: | PAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 82 TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | POTTSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 179013869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706225455 | ||||||||
| FaxNumber: | 5706225493 | ||||||||
| Practice Location | |||||||||
| Address1: | 48 TUNNEL RD | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | POTTSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 179013875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706225555 | ||||||||
| FaxNumber: | 5706226047 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 04/29/2016 | ||||||||
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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 | 207R00000X | MD035561E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | MD035561E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 0000169564 | 01 | PA | BLUE SHIELD | OTHER | 110031031 | 01 | PA | RAILROAD MECICARE PBA | OTHER | 116993900 | 01 | PA | FEDERAL EMPLOYEES COMP | OTHER | 50047346 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 0473231 | 01 | PA | US HEALTHCARE | OTHER | 09968130 | 01 | PA | KEYSTONE SPECIALIST | OTHER | 20075 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 0010734870001 | 05 | PA | MEDICAID | 01682001 | 01 | PA | KEYSTONE | OTHER | 020301000 | 01 | PA | FEDERAL BLACK LUNG | OTHER |