Provider Demographics
NPI:1710515408
Name:CHINNARAJ, GURU NANDHA RAJA (MD)
Entity Type:Individual
Prefix:
First Name:GURU NANDHA RAJA
Middle Name:
Last Name:CHINNARAJ
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 1:6850 LAKE NONA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827
Mailing Address - Country:US
Mailing Address - Phone:407-226-1106
Mailing Address - Fax:407-518-3923
Practice Address - Street 1:6850 LAKE NONA BOULEVARD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827
Practice Address - Country:US
Practice Address - Phone:407-226-1106
Practice Address - Fax:407-518-3923
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program