Individual
DR. CHANDRA SEKHAR PEMMASANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2435 W BELVEDERE AVE, SUITE 22, BALTIMORE, MD 21215-5224
(410) 601-6840
(410) 601-5789
Mailing address
2401 W BELVEDERE AVE, ATTN: CREDENTIALING, BALTIMORE, MD 21215-5216
(410) 601-5524
(410) 601-8946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0063121
MD
208M00000X
Hospitalist Physician
Primary
D0063121
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409198000
—
MD
01
—
C31152
R/R MEDICARE GROUP #
MD
01
—
P00267176
R/R MEDICARE PROVIDER #
MD
Enumeration date
06/04/2006
Last updated
08/17/2009
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