Individual
DR. LATCHAIAH CHIRUMAMILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 CONNIE AVE STE 204, SALEM, IN 47167-2313
(812) 755-4443
Mailing address
102 CONNIE AVE STE 204, SALEM, IN 47167-2313
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01046148A
IN
207R00000X
Internal Medicine Physician
01046148A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199040
MEDICARE OLD PIN
IN
05
—
200189350
—
IN
Enumeration date
03/28/2006
Last updated
06/14/2022
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