Provider Demographics
NPI:1821277716
Name:CHINTALPURI, SHASWITA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHASWITA
Middle Name:
Last Name:CHINTALPURI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-415-4101
Practice Address - Street 1:7500 80TH STREET SOUTH, SUITE 100 - MAIL STOP 34624A
Practice Address - Street 2:HEALTHPARTNERS COTTAGE GROVE CLINIC
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3008
Practice Address - Country:US
Practice Address - Phone:651-415-4100
Practice Address - Fax:651-415-4101
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2011-12-01
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Provider Licenses
StateLicense IDTaxonomies
NDRL10540207Q00000X
MN53549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12083Medicaid
ND12083Medicaid