Individual
SUDHISH CHANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5454 HOHMAN AVE, HAMMOND, IN 46320-1931
(219) 933-2300
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2649
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
01059766A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090000854
BCBS GROUP NUMBER
IL
05
—
200409950
—
IN
Enumeration date
09/29/2005
Last updated
07/19/2011
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