Provider Demographics
NPI:1669470464
Name:CHAGANTY, SYAMALA (MD)
Entity Type:Individual
Prefix:DR
First Name:SYAMALA
Middle Name:
Last Name:CHAGANTY
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 1:1309 LINKS CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9450
Mailing Address - Country:US
Mailing Address - Phone:757-436-9447
Mailing Address - Fax:
Practice Address - Street 1:7423 GRANBY ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3406
Practice Address - Country:US
Practice Address - Phone:757-451-5000
Practice Address - Fax:757-451-5005
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049520208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics