Individual
DR. CHANDRA MANNYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
890 OAK ST SE, SALEM, OR 97301-3905
(503) 814-7554
(601) 984-5503
Mailing address
PO BOX 13129, SALEM, OR 97309-1129
(035) 814-7557
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD213488
OR
Other
Enumeration date
07/11/2019
Last updated
06/30/2023
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