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Individual

PREM K.G. CHANDRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
411 LAUREL ST, SUITE 2350, DES MOINES, IA 50314
(515) 280-4700
(515) 280-4701
Mailing address
411 LAUREL ST STE 2350, DES MOINES, IA 50314-3026
(515) 280-4700
(515) 280-4701

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
24158
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13649
WELLMARK BCBS
IA
01
1518969104
WELLMARK BCBS
IA
05
1518969104
IA
01
P00329636
RAILROAD MEDICARE
IA
Enumeration date
08/12/2005
Last updated
01/07/2015
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