Individual
SHALINI CHITNENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2514 E DUPONT RD STE 100, FORT WAYNE, IN 46825-1619
(260) 484-8830
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301083885
MI
207RH0003X
Hematology & Oncology Physician
Primary
01068221A
IN
207RX0202X
Medical Oncology Physician
01068221A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000658592
ANTHEM
IN
01
—
000000693601
ANTHEM
IN
05
—
200980310
—
IN
05
—
3044977
—
OH
Enumeration date
05/15/2007
Last updated
12/17/2024
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