MEDICARE: DR. RAMESH CHADALAVADA 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	207RP1001X	Pulmonary Disease Physician	35644	TN
2	207R00000X	Internal Medicine Physician	127008	TN
3	207RP1001X	Pulmonary Disease Physician	146083	TN
4	207RS0012X	Sleep Medicine (Internal Medicine) Physician	35644	TN

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
2	4027347	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1487723342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMESH CHADALAVADA MD

Provider Business Mailing Address
First Line	:	221 NORTHCREST DR
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-3962
Country	:	US
Telephone Number	:	615-384-2149
Fax Number	:	615-384-9384

Provider Business Practice Location Address
First Line	:	221 NORTHCREST DR
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-3962
Country	:	US
Telephone Number	:	615-384-2149
Fax Number	:	615-384-9384

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	01/11/2010

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