Individual
CHANDRA R POLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
121 FREEPORT RD STE 200, BLAWNOX, PA 15238-3485
(412) 784-7180
(412) 784-7185
Mailing address
121 FREEPORT RD STE 200, BLAWNOX, PA 15238-3485
(412) 784-7180
(412) 784-7185
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD038348L
PA
207UN0901X
Nuclear Cardiology Physician
MD038348L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000915209
—
PA
05
—
000915209004
—
PA
05
—
0211079000
—
WV
05
—
0800020
—
OH
Enumeration date
03/22/2006
Last updated
03/24/2021
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