Individual
PREM K.G. CHANDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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