Individual
CHANDRAN VEDAMANIKAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3825 EUBANK BLVD NE STE H, ALBUQUERQUE, NM 87111-3559
(505) 350-3397
(505) 323-7980
Mailing address
700 S TELSHOR BLVD STE 1460, LAS CRUCES, NM 88011-8607
(575) 567-7774
(575) 205-0306
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
MD2012-0121
NM
207Q00000X
Family Medicine Physician
MD2012-0121
NM
207Q00000X
Family Medicine Physician
RS2008-0187
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61507334
—
NM
Enumeration date
07/10/2008
Last updated
02/09/2026
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