Individual
DR. CHANDRASEKHAR CHERUKUPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST, SUITE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01070273A
IN
2086S0129X
Vascular Surgery Physician
Primary
01070273A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000750011
ANTHEM
IN
01
—
01070273
INDIANA STATE LICENSE
IN
05
—
201047950
—
IN
05
—
7100186780
—
KY
Enumeration date
06/21/2007
Last updated
03/04/2024
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