Channaiah Srikanth Mysore
Psychiatry & Neurology, Neurology in Salisbury, MD. Individual provider (NPI-1).
NPI number1881900652
StatusActive
Last updated in NPPESJan 6, 2022
Details
- NPI
- 1881900652
- Entity type
- Individual (NPI-1)
- Name
- Channaiah Srikanth Mysore
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2010
- Certification date
- Jan 6, 2022
- Last updated
- Jan 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | D77961 | MD | Yes |
Practice location
100 E Carroll StSalisbury, MD 21801
Phone 800-749-5191
Mailing address
100 E Carroll StSalisbury, MD 21801-5493
Phone 800-749-5191
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