| Chandras Clinic Pc | |
|
1249 Fairview Avenue Se Salem OR 97302 | |
| (503) 269-9915 | |
| (503) 907-9933 |
| Full Name | Chandras Clinic Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1249 Fairview Avenue Se, Salem, Oregon |
| Authorized Official Name and Position | Satyanarayana Chandragiri (DIRECTOR) |
| Authorized Official Contact | 5032699915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chandras Clinic Pc Po Box 4060 1249 Fairview Avenue Se Salem OR 97302 Ph: (503) 269-9915 | Chandras Clinic Pc 1249 Fairview Avenue Se Salem OR 97302 Ph: (503) 269-9915 |
| NPI Number | 1366625881 |
|---|---|
| Provider Enumeration Date | 12/06/2007 |
| Last Update Date | 12/06/2007 |
| Medicare PECOS PAC ID | 0143302000 |
|---|---|
| Medicare Enrollment ID | O20080130000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366625881 | NPI | - | NPPES |
| 1376693275 | Other | OR | NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD22214 (Oregon) | Primary |
| Provider Name | Satyanarayana Chandragiri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376693275 PECOS PAC ID: 6002841756 Enrollment ID: I20050930000381 |
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