Individual
SURYA K CHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1365 WESTGATE CENTER DR STE N1, WINSTON SALEM, NC 27103-3106
(336) 765-3337
(336) 765-3133
Mailing address
232 GILMER ST, SUITE 206, REIDSVILLE, NC 27320-3860
(336) 347-7415
(336) 347-7419
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25241
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132VT
BCBS
NC
05
—
3410016
—
NC
05
—
89132VT
—
NC
Enumeration date
11/22/2005
Last updated
03/07/2023
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