Provider Demographics
NPI:1790829729
Name:CHENGAPPA, KAMBAYANDA SAVITHA (MD)
Entity Type:Individual
Prefix:
First Name:KAMBAYANDA
Middle Name:SAVITHA
Last Name:CHENGAPPA
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:PO BOX 1927
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-7927
Mailing Address - Country:US
Mailing Address - Phone:410-573-9511
Mailing Address - Fax:410-573-4816
Practice Address - Street 1:49 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3854
Practice Address - Country:US
Practice Address - Phone:410-573-9511
Practice Address - Fax:410-573-4816
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065940207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD013847900Medicaid
757LQ937Medicare PIN