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General NPI Number Information
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NPI Number | 1902175649
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Entity Type | Individual
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Provider Name | GAJAPATHIRAJU CHAMARTHI M.D
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Gender | Male
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 124 S UNIVERSITY BLVD STE A
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City | MOBILE
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State | AL
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Zip | 36608-3078
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Country | US
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Telephone | 513-435-0042
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Fax | 251-343-8383
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Provider Business Mailing Address
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Address Line | PO BOX 100224
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City | GAINESVILLE
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State | FL
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Zip | 32610-0224
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Country | US
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Telephone | 352-273-8822
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 45944
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME139158
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License Number State | FL
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