Provider Demographics
NPI:1659375681
Name:KALARIA, VRINDA PANKAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:VRINDA
Middle Name:PANKAJ
Last Name:KALARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VRINDA
Other - Middle Name:PANKAJ
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6098 DEBRA ROAD
Mailing Address - Street 2:6200 BLDG, 5200 STE
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411
Mailing Address - Country:US
Mailing Address - Phone:423-893-6500
Mailing Address - Fax:423-893-6563
Practice Address - Street 1:6098 DEBRA ROAD
Practice Address - Street 2:6200 BLDG, 5200 STE
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:423-893-6563
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00606526BMedicaid
GA038065OtherSTATE LICENSE
GAP00317032OtherRAILROAD MEDICARE
BP4048927OtherDEA
GAP00317032OtherRAILROAD MEDICARE
F83120Medicare UPIN