| Malini Chintapalli, Do, Apmc | |
|
1453 E Bert Kouns Industrial Loop Shreveport LA 71105-6800 | |
| (504) 813-4281 | |
| (318) 798-4601 |
| Full Name | Malini Chintapalli, Do, Apmc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1453 E Bert Kouns Industrial Loop, Shreveport, Louisiana |
| Authorized Official Name and Position | Malini Chintapalli (DO/OWNER) |
| Authorized Official Contact | 5048134281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malini Chintapalli, Do, Apmc Po Box 52244 Shreveport LA 71135-2244 Ph: (318) 798-4606 | Malini Chintapalli, Do, Apmc 1453 E Bert Kouns Industrial Loop Shreveport LA 71105-6800 Ph: (504) 813-4281 |
| NPI Number | 1508369562 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 03/15/2018 |
| Medicare PECOS PAC ID | 1557625233 |
|---|---|
| Medicare Enrollment ID | O20180504000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508369562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | DO.000340 (Louisiana) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | DO.000340 (Louisiana) | Secondary |
| Provider Name | Deanna Kamphuis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437153319 PECOS PAC ID: 0244299477 Enrollment ID: I20041005000233 |
| Provider Name | Malini Chintapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336468792 PECOS PAC ID: 1254502651 Enrollment ID: I20140131000890 |
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