Individual
CHANDRAMA CHAKRABARTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4525 SPRINGHILL JUNCTION, TERRE HAUTE, IN 47802
(812) 234-6053
(812) 478-3416
Mailing address
4525 SPRINGHILL JUNCTION, TERRE HAUTE, IN 47802
(812) 234-6053
(812) 478-3416
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01050624A
IN
2080P0208X
Pediatric Infectious Diseases Physician
01050624A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000244694
BLUE CROSS PROVIDER #
—
05
—
200414010
—
IN
Enumeration date
01/18/2006
Last updated
03/12/2010
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