MEDICARE: DR. ANANDA B CHELLAPPAN 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	2084P0800X	Psychiatry Physician	0101035017	VA

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	:	1235215153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANANDA B CHELLAPPAN M.D.

Provider Business Mailing Address
First Line	:	4906 CUTSHAW AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-3630
Country	:	US
Telephone Number	:	804-355-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	4906 CUTSHAW AVE
Second Line	:	SUITE 105
City	:	RICHMOND
State	:	VA
Zip	:	23230-3630
Country	:	US
Telephone Number	:	804-355-4545
Fax Number	:

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	10/06/2008

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