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DR. VANDANA CHAKRAVARTHY CENTA D.O
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1881607000
Individual Registrant:DR. VANDANA CHAKRAVARTHY CENTA D.O
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
11 CHARLIE MORRIS RD COLBERT, GA 30628-2445 US
Tel: 706-788-3234 Fax: 706-788-2936
Tel: 706-788-3234 Fax: 706-788-2936
Contact information for business:
PO BOX 459 COLBERT, GA 30628-0459 US
Tel: 706-788-3234 Fax: 706-788-2936
Tel: 706-788-3234 Fax: 706-788-2936
Registration Information:
NPI: 1881607000
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | GA | 057054 |
| N | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | AZ | 3099 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 136315049C | GA | 05 |
