# PURNA CHETTRI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487815221
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 41585 | AZ | Yes |

## Other

- **Enumeration date:** 06/24/2008
- **Last updated:** 09/24/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1174514756 | YOUR FAMILY PHYSICIAN | AZ |
| 01 | — | Z22506 | MEDICARE GROUP PIN | AZ |