Healthcare Provider Details

I. General information

NPI: 1245989409
Provider Name (Legal Business Name): NIHARA CHAKRALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HURLEY PLZ OFC 10W
FLINT MI
48503-5902
US

IV. Provider business mailing address

14 SANIBEL CT
MONROE NJ
08831-5817
US

V. Phone/Fax

Practice location:
  • Phone: 810-262-9000
  • Fax:
Mailing address:
  • Phone: 609-787-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA12849100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: