Mohan, Chandler Vimal

Mohan, Chandler Vimal is an individual health care provider with primary practice located at 4812 W Us Highway 90 , Lake City FL 32055-5126. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Mohan, Chandler Vimal can be contacted via phone (386) 466-1106.

Contact Information

Primary practice address
4812 W Us Highway 90 Lake City FL 32055-5126
Phone: (386) 466-1106
Fax: (386) 466-1821
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 0101243179 Virginia
Allopathic & Osteopathic Physicians / General Practice 208D00000X 0101243179 Virginia
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X ME101708 Florida
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X ME101708 Florida

Profile Details

NPI number 1629239561
LBN Legal business name Mohan, Chandler Vimal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2008
Last updated Nov 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629239561 NPPES
Virginia MEDICAID 1629239561
Virginia MEDICAID 002878500

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