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NPI Code Detail

MEDICARE: CHENNAIAH NADINDLA MD

MEDICARE: CHENNAIAH NADINDLA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician036052876IL
2207P00000XEmergency Medicine PhysicianR6025MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639283195
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHENNAIAH NADINDLA MD
Provider Business Mailing Address
First Line : 1836 LACKLAND HILL PKWY
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-3572
Country : US
Telephone Number : 314-872-1439
Fax Number :
Provider Business Practice Location Address
First Line : 5900 BOND AVE
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62207-2326
Country : US
Telephone Number : 618-332-5212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 09/21/2009

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Directions to “ CHENNAIAH NADINDLA MD” Practice Location

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