Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 55823 | AZ |
NPI | 1063823078 |
---|---|
Provider Name | Soumini Chintala |
First Address | Phoenix, AZ 85016-7710 |
Second Address | Phoenix, AZ 85013-4409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2014 |
Last Update Date | 15/12/2021 |