Chalasani, Padmaja
Chalasani, Padmaja is an individual health care provider with primary practice located at Grand Lake Primary Care At St Marys 1140 S Knoxville Ave Ste A, Saint Marys OH 45885-2609. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Chalasani, Padmaja can be contacted via phone (419) 394-9959.Contact Information
Primary practice address
Grand Lake Primary Care At St Marys 1140 S Knoxville Ave Ste A
Saint Marys OH 45885-2609
Phone: (419) 394-9959
Fax: (419) 394-0255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35.074537 | Ohio |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35.074537 | Ohio |
Profile Details
| NPI number | 1023113693 |
|---|---|
| LBN Legal business name | Chalasani, Padmaja |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Jan 24th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023113693 | NPPES |
| Ohio | Other | 9934723 | ORGANIZATIONAL MEDICARE PTAN |
| Ohio | Other | H348972 | ORGANIZATIONAL MEDICARE PTAN |
| Ohio | MEDICAID | 2079076 | ORGANIZATIONAL MEDICARE PTAN |
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