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Individual

CHANDY C SAMUEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3625 QUAIL RIDGE RD, WINFIELD, KS 67156-8881
(620) 221-6100
(620) 221-7680
Mailing address
3625 QUAIL RIDGE RD, WINFIELD, KS 67156-8881
(620) 221-6100
(620) 221-7680

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
04-16859
KS
208600000X
Surgery Physician
Primary
0416859
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100085170A
KS
Enumeration date
09/08/2005
Last updated
10/20/2008
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