Provider Demographics
NPI:1831972447
Name:CHINCHOLI, TEJAS SURESH (MD)
Entity type:Individual
Prefix:
First Name:TEJAS
Middle Name:SURESH
Last Name:CHINCHOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6663
Mailing Address - Country:US
Mailing Address - Phone:901-355-4525
Mailing Address - Fax:
Practice Address - Street 1:1211 UNION AVE STE 340
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6663
Practice Address - Country:US
Practice Address - Phone:901-355-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program