{
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"EIN": null,
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"OrgName": "FAMILY MEDICAL OFFICES OF DR. CHENCHUGALLA, M.D., PC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "7411 RIGGS RD",
"SecondLineMailingAddress": "SUITE 304",
"MailingAddressCityName": "ADELPHI",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20783-4246",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-445-1452",
"MailingAddressFaxNumber": "301-560-0841",
"FirstLinePracticeLocationAddress": "7411 RIGGS RD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-445-1452",
"PracticeLocationAddressFaxNumber": "301-560-0841",
"EnumerationDate": "09/24/2008",
"LastUpdateDate": "02/09/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHENCHUGALLA",
"AuthorizedOfficialFirstName": "MANOHAR",
"AuthorizedOfficialMiddleName": "KUMAR",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "301-445-1452",
"Taxonomies": {
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{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}