Organization
L CHIRUMAMILLA MD PC
Active
Organization
L CHIRUMAMILLA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATCHAIAH CHIRUMAMILLA MD (OWNER)
(812) 883-0090
Entity
Organization
Contact information
Practice address
505 W HOMER ST, SUITE 201, SALEM, IN 47167-1698
(812) 883-0090
(812) 883-0199
Mailing address
505 W HOMER ST, SUITE 201, SALEM, IN 47167-1698
(812) 883-0090
(812) 883-0199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1046148
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200189350
—
IN
Enumeration date
06/10/2010
Last updated
07/10/2010
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