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Individual

CHANDULAL D GHODASARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
915 WEST MICHIGAN ST, BUILDING A, SIDNEY, OH 45365-2401
(937) 492-5445
(937) 492-4836
Mailing address
915 WEST MICHIGAN ST, SIDNEY, OH 45365-2401
(937) 492-5445
(937) 492-4836

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-06-5247G
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0937704
OH
Enumeration date
05/10/2006
Last updated
07/21/2009
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