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General NPI Number Information
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NPI Number | 1255507109
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Entity Type | Organization
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Legal Business Name | CHANDRASEKHAR GOLLA MD
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 9401 MCKNIGHT RD SUITE 302
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City | PITTSBURGH
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State | PA
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Zip | 15237-6000
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Country | US
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Telephone | 412-364-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 9401 MCKNIGHT RD SUITE 302
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City | PITTSBURGH
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State | PA
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Zip | 15237-6000
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Country | US
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Telephone | 412-364-0333
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Fax |
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Authorized Official
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Title or Position | MD SOLE PROPRIETOR
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Name | CHANDRASEKHAR GOLLA
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Credential | MD
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Telephone | 412-364-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0386611L
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License Number State | PA
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