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General NPI Number Information
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NPI Number | 1508982273
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Entity Type | Individual
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Provider Name | MANOHAR KUMAR CHENCHUGALLA MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 2700 HEALING WAY SUITE 320
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5453
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Country | US
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Telephone | 813-779-6303
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Fax | 888-977-1998
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Provider Business Mailing Address
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Address Line | 2700 HEALING WAY SUITE 320
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5453
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Country | US
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Telephone | 813-779-6303
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Fax | 888-977-1998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME114742
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME114742
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License Number State | FL
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