Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4301502783 | MI |
NPI | 1003237934 |
---|---|
Provider Name | Jahnavi Chakrala |
First Address | Saint Clair Shores, MI 48080-1775 |
Second Address | Saint Clair Shores, MI 48080-1775 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2013 |
Last Update Date | 25/06/2020 |