MEDICARE: DR. RAM M CHALLAPALLI M.D.

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	207RC0000X	Cardiovascular Disease Physician	8454	NV
2	207RC0000X	Cardiovascular Disease Physician	A71052	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154313815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAM M CHALLAPALLI M.D.

Provider Business Mailing Address
First Line	:	645 N ARLINGTON AVE
Second Line	:	STE 460
City	:	RENO
State	:	NV
Zip	:	89503-4451
Country	:	US
Telephone Number	:	775-770-7622
Fax Number	:	775-770-3683

Provider Business Practice Location Address
First Line	:	75 PRINGLE WAY
Second Line	:	SUITE 401
City	:	RENO
State	:	NV
Zip	:	89502-1464
Country	:	US
Telephone Number	:	775-688-8000
Fax Number	:	775-688-8031

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	11/08/2016

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