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Individual

ARAVIND CHANDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-8000
Mailing address
PROVIDENCE PORTLAND MEDICAL CENTER, 4805 NE GLISAN STREET, PORTLAND, OR 97213

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
67829-20
WI
207R00000X
Internal Medicine Physician
Primary
MD184823
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP10049445
BP NUMBER
TX
Enumeration date
05/12/2014
Last updated
12/06/2019
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