Basic Information
| Provider Information | |||||||||
| NPI: | 1871235911 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHINNAPPA | ||||||||
| FirstName: | MAAYA | ||||||||
| MiddleName: | AJAY | ||||||||
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| OtherLastName: | CHINNAPPA | ||||||||
| OtherFirstName: | ASHNA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | VCUHS GMEA | ||||||||
| Address2: | BOX 980257 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232980257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048289783 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | VCUHS DEPT OF PEDIATRICS RESIDENCY | ||||||||
| Address2: | 1250 E. MARSHALL STREET | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232980257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048270534 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2022 | ||||||||
| LastUpdateDate: | 06/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.