MEDICARE: NAGESWARA RAO CHUNDURU

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
1	2084P0800X	Psychiatry Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1912107483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAGESWARA RAO CHUNDURU

Provider Business Mailing Address
First Line	:	528 N UNIVERSITY ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-3012
Country	:	US
Telephone Number	:	615-867-3780
Fax Number	:	615-867-3786

Provider Business Practice Location Address
First Line	:	528 N UNIVERSITY ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-3012
Country	:	US
Telephone Number	:	615-867-3780
Fax Number	:	615-867-3786

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NAGESWARA RAO CHUNDURU
Credential	:	MD
Telephone Number	:	615-867-3780

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	10/02/2007

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