Provider Demographics
NPI:1609173954
Name:CHAGANTI, UMA DEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:UMA
Middle Name:DEVI
Last Name:CHAGANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CAREW ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2391
Mailing Address - Country:US
Mailing Address - Phone:413-734-8254
Mailing Address - Fax:413-747-5870
Practice Address - Street 1:175 CAREW ST STE 200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2391
Practice Address - Country:US
Practice Address - Phone:413-734-8254
Practice Address - Fax:413-747-5870
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMC0830542AOtherCONTROLLED SUBSTANCE REGISTRATION
MA52508OtherHNE
MA52508OtherHNE
MA1310097Medicaid
MA1310097Medicaid
MA221883Medicare Oscar/Certification