Individual
DR. CHAITANYA VIJAY BRUNDAVANAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-3637
(906) 776-5316
(906) 776-5761
Mailing address
1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-3637
(906) 776-5316
(906) 776-5761
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301088796
MI
208M00000X
Hospitalist Physician
4301088796
MI
Other
Enumeration date
04/18/2007
Last updated
10/04/2023
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