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General NPI Number Information
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NPI Number | 1811070022
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Entity Type | Individual
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Provider Name | HARAGA CHENGAPPA MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 265 MAIN ST BELLEVILLE HEALTH CARE PC
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City | BELLEVILLE
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State | MI
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Zip | 48111
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Country | US
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Telephone | 734-697-9300
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Fax | 734-697-0374
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Provider Business Mailing Address
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Address Line | 265 MAIN ST BELLEVILLE HEALTH CARE PC
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City | BELLEVILLE
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State | MI
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Zip | 48111
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Country | US
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Telephone | 734-697-9300
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Fax | 734-697-0374
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301062555
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License Number State | MI
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