Provider Demographics
NPI:1952633810
Name:CHEPPALLI, NAGA SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGA SURESH
Middle Name:
Last Name:CHEPPALLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:700 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4765
Mailing Address - Country:US
Mailing Address - Phone:843-383-3742
Mailing Address - Fax:843-383-3745
Practice Address - Street 1:500 WALTER ST NE STE 104
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2541
Practice Address - Country:US
Practice Address - Phone:505-727-4430
Practice Address - Fax:505-727-9590
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40073207X00000X
WAMD60372855207X00000X
NMMD2017-0939207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery