Reddivari, Chandra S
Reddivari, Chandra S is an individual health care provider with primary practice located at 200 Mill Road Suite 190, Fairhaven MA 02719-5252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Reddivari, Chandra S can be contacted via phone (508) 973-0857.Contact Information
Primary practice address
200 Mill Road Suite 190
Fairhaven MA 02719-5252
Phone: (508) 973-0857
Fax: (508) 973-2176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 152438 | Massachusetts |
Profile Details
| NPI number | 1477522290 |
|---|---|
| LBN Legal business name | Reddivari, Chandra S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Apr 24th, 2020 - about 6 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 | 1477522290 | NPPES |
| Massachusetts | MEDICAID | 177806 |
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