Individual
DR. JAIDEEP CHUNDURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6480 HARRISON AVENUE, SUITE 201, CINCINNATI, OH 45247
(513) 354-3700
(513) 354-7601
Mailing address
6480 HARRISON AVENUE, SUITE 100, CINCINNATI, OH 45247
(513) 354-3700
(513) 354-7601
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
35-08-2366
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000287763
ANTHEM
OH
05
—
200197870
—
IN
05
—
2412222
—
OH
01
—
3207090
AETNA
OH
01
—
409602
WELLCARE
OH
01
—
82366
HUMANA
OH
01
—
P00042913
RAILROAD MEDICARE
OH
Enumeration date
10/24/2005
Last updated
10/02/2012
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