MEDICARE: ANURADHA C CHALLA 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	TP391	KY
2	2084P0800X	Psychiatry Physician	4301094811	MI
3	2084P0800X	Psychiatry Physician	C161974	CA
4	2084P0800X	Psychiatry Physician	49709	KY
5	2084P0800X	Psychiatry Physician	2019-00312	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	NN8165A	OTHER	NC	MEDICARE PTAN

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	:	1518195825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANURADHA C CHALLA M.D.,

Provider Business Mailing Address
First Line	:	323 N STATE ST
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-1537
Country	:	US
Telephone Number	:	989-673-6191
Fax Number	:

Provider Business Practice Location Address
First Line	:	31625 HIGHWAY 101 S
Second Line	:
City	:	SOLEDAD
State	:	CA
Zip	:	93960-9529
Country	:	US
Telephone Number	:	831-678-5500
Fax Number	:

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

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	03/27/2026

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Directions to “ ANURADHA C CHALLA M.D.,” Practice Location

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