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Individual

DR. CHANDRASEKHAR R VASAMREDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MERCY WAY, SUITE 320, JOPLIN, MO 64804
(417) 781-5387
(417) 781-7174
Mailing address
100 MERCY WAY, SUITE 320, JOPLIN, MO 64804
(417) 781-5387
(417) 781-7174

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
04-33682
KS
207RC0000X
Cardiovascular Disease Physician
24539
OK
207RC0000X
Cardiovascular Disease Physician
KSDEA-FV1379646
KS
207RC0000X
Cardiovascular Disease Physician
MO-2009008971
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
04-33682
KS
207RC0001X
Clinical Cardiac Electrophysiology Physician
2009008971
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1265572481
MO
05
200611200A
KS
01
450A00003A
MEDICARE JACKSON COUNTY
MO
01
450D00003D
MEDICARE JOHNSON COUNTY
KS
01
67A00005
MEDICARE PTANK
KS
01
K67000014
MEDICARE PTAN
KS
Enumeration date
02/07/2007
Last updated
05/08/2025
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