Organization
V. RAJA CHANDRA, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKATAPERUMAL R CHANDRASEKARAN MD (OWNER)
(307) 324-2294
Entity
Organization
Contact information
Practice address
519 8TH ST, RAWLINS, WY 82301-5460
(307) 324-2294
(307) 328-1964
Mailing address
519 8TH ST, PO BOX 1768, RAWLINS, WY 82301-5460
(307) 324-2294
(307) 328-1964
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
2812A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00072001
BCBS
WY
05
—
106489400
—
WY
01
—
760011087
RAILROAD MEDICARE
WY
Enumeration date
12/02/2009
Last updated
12/02/2009
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