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General NPI Number Information
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NPI Number | 1386789964
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Entity Type | Organization
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Legal Business Name | CHAPALAMADUGU GANGADHARARAO MD PA
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 300 RIVERSIDE DRIVE EAST SUITE 4500
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City | BRADENTON
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State | FL
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Zip | 34208
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Country | US
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Telephone | 941-746-1018
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Fax | 941-747-3684
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Provider Business Mailing Address
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Address Line | 300 RIVERSIDE DRIVE EAST SUITE 4500
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City | BRADENTON
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State | FL
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Zip | 34208
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Country | US
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Telephone | 941-746-1018
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Fax | 941-747-3684
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Authorized Official
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Title or Position | PRESIDENT
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Name | CG RAO
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Credential | MD
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Telephone | 941-746-1018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME 0030551
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License Number State | FL
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