Provider Demographics
NPI:1508369562
Name:MALINI CHINTAPALLI, DO, APMC
Entity Type:Organization
Organization Name:MALINI CHINTAPALLI, DO, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINTAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:504-813-4281
Mailing Address - Street 1:PO BOX 52244
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-2244
Mailing Address - Country:US
Mailing Address - Phone:318-798-4606
Mailing Address - Fax:318-798-4601
Practice Address - Street 1:1453 E BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-6800
Practice Address - Country:US
Practice Address - Phone:504-813-4281
Practice Address - Fax:318-798-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADO.000340207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty