Desaraju, Chakradhar

Desaraju, Chakradhar is an individual health care provider with primary practice located at 6201 N Suncoast Blvd , Crystal River FL 34428-6712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Desaraju, Chakradhar can be contacted via phone (352) 795-6560.

Contact Information

Primary practice address
6201 N Suncoast Blvd Crystal River FL 34428-6712
Phone: (352) 795-6560
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME93164 Florida

Profile Details

NPI number 1558344069
LBN Legal business name Desaraju, Chakradhar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Jul 9th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558344069 NPPES
Florida Other ME93164 STATE LICENSSE NUMBER
Florida MEDICAID 280320800 STATE LICENSSE NUMBER
Florida Other 29576 STATE LICENSSE NUMBER
Florida Other 9010415 STATE LICENSSE NUMBER
Florida Other P00294598 STATE LICENSSE NUMBER

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