Organization
VIJAYA CHALLA, M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAYA CHALLA M.D. (OWNER/PHYSICIA)
(810) 449-5456
Entity
Organization
Contact information
Practice address
7445 ALLEN RD, SUITE 180, ALLEN PARK, MI 48101-1963
(810) 449-5456
Mailing address
7445 ALLEN RD, SUITE 180, ALLEN PARK, MI 48101-1963
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
VC080035
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4865150
—
MI
Enumeration date
06/27/2012
Last updated
06/27/2012
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