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Individual

DR. RAM CHANDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
408 N 4TH ST STE B, ODESSA, MO 64076-1646
(816) 633-1630
(816) 633-1637
Mailing address
408 N 4TH ST STE B, ODESSA, MO 64076-1646
(816) 633-1630
(816) 633-1637

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
105321
MO
207Q00000X
Family Medicine Physician
Primary
105321
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010568509
MO
01
20974021
BCBS
01
20974041
BCBS
01
20974051
BCBS
05
246986129
MO
05
540568508
MO
05
595956202
MO
Enumeration date
05/01/2006
Last updated
01/13/2014
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