Individual
CHANDRA M MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
141 N VINE ST, HAZLETON, PA 18201
(570) 454-2467
(570) 455-2070
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD030327E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001122901-0003
—
PA
05
—
0011229010001
—
PA
01
—
080335
FIRST PRIORITY HEALTH
—
01
—
50005161
CAPITAL BLUE CROSS
PA
01
—
P00092581
RAILROAD MEDICARE
PA
Enumeration date
06/06/2006
Last updated
02/19/2020
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