Provider Demographics
NPI:1033162557
Name:CHIRAPA SINTHUSEK, PA
Entity Type:Organization
Organization Name:CHIRAPA SINTHUSEK, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIRAPA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINTHUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-765-6897
Mailing Address - Street 1:730 HIGHLAND OAKS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7108
Mailing Address - Country:US
Mailing Address - Phone:336-765-6897
Mailing Address - Fax:336-765-7306
Practice Address - Street 1:730 HIGHLAND OAKS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7108
Practice Address - Country:US
Practice Address - Phone:336-765-6897
Practice Address - Fax:336-765-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18717261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8976665Medicaid
NC1033162557Medicare PIN
NC8976665Medicaid