MEDICARE: ANEESHA CHEEDALLA 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	207V00000X	Obstetrics & Gynecology Physician	57.249428	OH

General Provider Information

NPI Number	:	1558878314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANEESHA CHEEDALLA MD

Provider Business Mailing Address
First Line	:	3651 BRINELL ST E APT 300
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3795
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 W 10TH AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1240
Country	:	US
Telephone Number	:	614-293-8045
Fax Number	:

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

Provider Enumeration Date	:	01/02/2018
Last Update Date	:	10/23/2024

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