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Individual

CHANDRA R. SHAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., F.A.A.P.

Contact information

Practice address
120 STURGES AVE STE 1, MANSFIELD, OH 44903-2399
(419) 522-5454
(419) 522-2981
Mailing address
120 STURGES AVE STE 1, MANSFIELD, OH 44903-2399
(419) 522-5454
(419) 522-2981

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35042404S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0370781
OH
Enumeration date
01/31/2007
Last updated
12/19/2011
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