Organization
DB CHANDORA MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEN B CHANDORA MD (OWNER)
(404) 550-3248
Entity
Organization
Contact information
Practice address
362 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2560
(404) 550-3248
(770) 892-5259
Mailing address
565 LAKE FRONT DR, LILBURN, GA 30047-7317
(404) 550-3248
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
25954
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137472A
—
GA
Enumeration date
09/22/2013
Last updated
11/07/2013
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