Provider Demographics
NPI:1144232133
Name:CHARI, NAGALINGAPPA BHADRA (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGALINGAPPA
Middle Name:BHADRA
Last Name:CHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NAGALINGAPPA
Other - Middle Name:BHADRA
Other - Last Name:CHARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:29900 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-2656
Mailing Address - Country:US
Mailing Address - Phone:586-294-4440
Mailing Address - Fax:
Practice Address - Street 1:29900 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-2656
Practice Address - Country:US
Practice Address - Phone:586-294-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301034294208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0500005Medicare PIN
MIE42400Medicare UPIN