Provider Demographics
NPI:1083665574
Name:VARMA, CHINTALAPATI (MD,FRCS,FAC)
Entity Type:Individual
Prefix:MR
First Name:CHINTALAPATI
Middle Name:
Last Name:VARMA
Suffix:
Gender:M
Credentials:MD,FRCS,FAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 VISA AVE. AT GRAND BLVD.
Mailing Address - Street 2:FDT - 11TH FLOOR
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-577-8829
Mailing Address - Fax:314-268-5400
Practice Address - Street 1:1225 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1016
Practice Address - Country:US
Practice Address - Phone:314-257-3760
Practice Address - Fax:314-257-3761
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113503204F00000X, 208600000X
PAMD428212208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101503938Medicaid
G40110Medicare UPIN
PA101503938Medicaid