MEDICARE: MEDHA CHUNDURU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	T8511	TX
2	207Q00000X	Family Medicine Physician	MD226931	OR

General Provider Information

NPI Number	:	1013395086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEDHA CHUNDURU MD

Provider Business Mailing Address
First Line	:	500 NE MULTNOMAH ST STE 100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2031
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4855 SW WESTERN AVE
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-3460
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	02/11/2026

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Directions to “ MEDHA CHUNDURU MD” Practice Location

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