Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 00020712 | AL |
NPI | 1083635015 |
---|---|
Provider Name | Vishala Chindalore |
First Address | Anniston, AL 36202-2127 |
Second Address | Anniston, AL 36207-5710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 16/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000035561 | (05) | AL |
3210013 | UNITED HEALTHCARE (01) | AL |
G56389 | (02) | AL |