Provider Demographics
NPI:1275601833
Name:CHINTALAPUDI, GIRIDHAR (MD)
Entity Type:Individual
Prefix:
First Name:GIRIDHAR
Middle Name:
Last Name:CHINTALAPUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 OLMSTED BLVD
Mailing Address - Street 2:MELLON BLDG. STE. 12
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9131
Mailing Address - Country:US
Mailing Address - Phone:910-235-0595
Mailing Address - Fax:910-235-0546
Practice Address - Street 1:295 OLMSTED BLVD BLDG STE 12
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8734
Practice Address - Country:US
Practice Address - Phone:910-235-0595
Practice Address - Fax:910-235-0546
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000196174400000X, 2084N0008X, 2084S0012X, 2084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891257JMedicaid
NC130022228OtherRAILROAD MEDICARE
NC1257JOtherBLUE CROSS BLUE SHIELD NC
NC2280180Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
NC130022228OtherRAILROAD MEDICARE