Organization
CHANDRASEKHAR POLEPALLE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY HARRIS (OFFICE MANAGER)
(918) 683-5939
Entity
Organization
Contact information
Practice address
3720 W BROADWAY ST, MUSKOGEE, OK 74401-2141
(918) 683-5939
(918) 686-5590
Mailing address
3720 W BROADWAY ST, MUSKOGEE, OK 74401-2141
(918) 683-5939
(918) 686-5590
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176625676P
MEDICARE PTAN
—
Enumeration date
02/24/2012
Last updated
02/24/2012
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