Individual
KAVITHA CHINTALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
(313) 916-1249
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301076920
MI
2080P0202X
Pediatric Cardiology Physician
Primary
4301076920
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KC076920
CHAMPUS-CHAMPUS
—
Enumeration date
06/01/2006
Last updated
10/04/2007
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