Provider Demographics
NPI:1063404721
Name:CHALLAPALLI, SRIDEVI (MD)
Entity type:Individual
Prefix:DR
First Name:SRIDEVI
Middle Name:
Last Name:CHALLAPALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 RENO CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2381
Mailing Address - Country:US
Mailing Address - Phone:775-384-1134
Mailing Address - Fax:775-284-1523
Practice Address - Street 1:5375 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2381
Practice Address - Country:US
Practice Address - Phone:775-384-1134
Practice Address - Fax:775-284-1523
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71053207RC0000X
NV8810207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016364Medicaid
NVG45856Medicare UPIN
NV31471Medicare PIN
NV2016364Medicaid