Provider Demographics
NPI:1770837270
Name:IRAGAVARAPU, CHAITANYA (MBBS)
Entity Type:Individual
Prefix:
First Name:CHAITANYA
Middle Name:
Last Name:IRAGAVARAPU
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR RM H0101
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2295
Mailing Address - Country:US
Mailing Address - Phone:650-723-0837
Mailing Address - Fax:
Practice Address - Street 1:UK HEMATOLOGY/ BMT CLINIC
Practice Address - Street 2:800 ROSE ST ROACH CANCER CTR 1ST FL
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-257-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155620207RH0003X
390200000X
KY49532207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA156620OtherMEDICAL BOARD OF CALIFORNIA