Individual
SRIDIVYA CHAVALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
76600
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100202579
—
WI
Enumeration date
04/14/2017
Last updated
06/30/2022
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