Individual
CHANDRA VETHODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 E CHESTNUT ST # 5A, LOUISVILLE, KY 40202-1713
(502) 588-2349
(502) 588-9535
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53464
KY
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
53464
KY
Other
Enumeration date
07/11/2015
Last updated
10/29/2020
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