Provider Demographics
NPI:1043009715
Name:SREENIVASAN, CHITHRA (MD)
Entity type:Individual
Prefix:
First Name:CHITHRA
Middle Name:
Last Name:SREENIVASAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13311 E SORREL LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-6315
Mailing Address - Country:US
Mailing Address - Phone:623-552-9981
Mailing Address - Fax:
Practice Address - Street 1:2024 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1111
Practice Address - Country:US
Practice Address - Phone:334-440-3061
Practice Address - Fax:334-261-2859
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program