Provider Demographics
NPI:1851567572
Name:V. CHOWDRY PINNAMANENI, M.D., P.C.
Entity Type:Organization
Organization Name:V. CHOWDRY PINNAMANENI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:V. CHOWDRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNAMANENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-466-0724
Mailing Address - Street 1:PO BOX 40685
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-0685
Mailing Address - Country:US
Mailing Address - Phone:317-333-9960
Mailing Address - Fax:317-338-9087
Practice Address - Street 1:8335 NAAB RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1919
Practice Address - Country:US
Practice Address - Phone:317-338-9000
Practice Address - Fax:317-338-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056444A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INH76544Medicare UPIN