Individual
SUBRAMANIYAM CHANDRASEKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 KEVIN DR, NEW MARTINSVILLE, WV 26155-2757
(304) 455-5910
(304) 455-2870
Mailing address
PO BOX 244, NEW MARTINSVILLE, WV 26155-0244
(304) 233-9314
(304) 233-0265
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20461
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1807689000
—
WV
05
—
2700152
—
OH
Enumeration date
05/17/2006
Last updated
07/09/2010
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