Prabhudev, Chandana
Prabhudev, Chandana is an sole proprietor health care provider with primary practice located at 1661 W Mcintosh Rd , Griffin GA 30223-1717. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Prabhudev, Chandana can be contacted via phone (770) 233-4668.Contact Information
Primary practice address
1661 W Mcintosh Rd
Griffin GA 30223-1717
Phone: (770) 233-4668
Fax: (678) 666-5131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 055272 | Georgia |
Profile Details
| NPI number | 1154400547 |
|---|---|
| LBN Legal business name | Prabhudev, Chandana |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 4th, 2006 |
| Last updated | Mar 20th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154400547 | NPPES |
| Georgia | MEDICAID | 785450399C |
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