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Individual

SUJAY KUMAR KANNAMANGALA CHANDRASHEKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
758 HIGHWAY 46 S, DICKSON, TN 37055-2556
(615) 446-2708
(615) 446-1357
Mailing address
127 CRESTVIEW PARK DR, SUITE 209, DICKSON, TN 37055-2855
(615) 446-5121
(615) 446-1357

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD54596
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD54596
MEDICAL LICENSE
TN
05
Q022894
TN
Enumeration date
04/04/2007
Last updated
11/17/2016
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