Provider Demographics
NPI:1720767924
Name:CHAGANTI, JOGA RAO (MD, FRANZCR, PHD)
Entity Type:Individual
Prefix:PROF
First Name:JOGA
Middle Name:RAO
Last Name:CHAGANTI
Suffix:
Gender:M
Credentials:MD, FRANZCR, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 S PENN SQ UNIT 33H
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2551
Mailing Address - Country:US
Mailing Address - Phone:484-332-4145
Mailing Address - Fax:
Practice Address - Street 1:132 S 10TH STREETS
Practice Address - Street 2:MAIN BUIDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-955-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4798732085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology