Individual
CHANDAN MAZUMDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 W WALL ST STE C, MIDLAND, TX 79701-6568
(432) 221-2500
(432) 687-1914
Mailing address
4214 ANDREWS HWY STE 240, MIDLAND, TX 79703-4817
(432) 686-6605
(432) 682-2284
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME 98432
FL
208000000X
Pediatrics Physician
Primary
P3771
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279640600
—
FL
05
—
305512101
—
TX
Enumeration date
05/07/2007
Last updated
07/28/2020
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