Provider Demographics
NPI:1992756563
Name:CHALLA, USHASRI (MD)
Entity type:Individual
Prefix:DR
First Name:USHASRI
Middle Name:
Last Name:CHALLA
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 1:818 N EMPORIA ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3729
Mailing Address - Country:US
Mailing Address - Phone:316-263-5891
Mailing Address - Fax:316-263-3083
Practice Address - Street 1:818 N EMPORIA ST
Practice Address - Street 2:SUITE 310
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3729
Practice Address - Country:US
Practice Address - Phone:316-263-5891
Practice Address - Fax:316-263-3083
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27373207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
331830OtherFIRST GUARD
OK100011800AMedicaid
KS100319350AMedicaid
KS054009OtherBLUE CROSS BLUE SHIELD
390005884OtherRAILROAD MEDICARE
KS100319350AMedicaid
G73916Medicare UPIN