Healthcare Provider Details

I. General information

NPI: 1053940007
Provider Name (Legal Business Name): ANISHA RAO CHINTHALAPALLY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US

IV. Provider business mailing address

5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-7273
  • Fax: 816-271-7376
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2024036708
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: