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General NPI Number Information
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NPI Number | 1710812730
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Entity Type | Individual
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Provider Name | KALYAN SAI CHADALAVADA DO
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Gender | Male
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 315 S OSTEOPATHY AVE
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City | KIRKSVILLE
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State | MO
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Zip | 63501-6401
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Country | US
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Telephone | 660-785-1400
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Fax | 660-785-1154
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Provider Business Mailing Address
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Address Line | 145 BELLA VISTA DR
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3352
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Country | US
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Telephone | 615-815-7622
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2026026732
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License Number State | MO
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