| East Tn Neurology Of Chattanooga | |
|
1720 Gunbarrel Rd Ste 306 Chattanooga TN 37421-3192 | |
| (423) 790-1529 | |
| Not Available |
| Full Name | East Tn Neurology Of Chattanooga |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1720 Gunbarrel Rd Ste 306, Chattanooga, Tennessee |
| Authorized Official Name and Position | Subroto Kundu (OWNER) |
| Authorized Official Contact | 4237901529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Tn Neurology Of Chattanooga 3555 Keith St Nw Ste 211 Cleveland TN 37312-4375 Ph: (423) 476-5406 | East Tn Neurology Of Chattanooga 1720 Gunbarrel Rd Ste 306 Chattanooga TN 37421-3192 Ph: (423) 790-1529 |
| NPI Number | 1538424072 |
|---|---|
| Provider Enumeration Date | 07/11/2012 |
| Last Update Date | 11/29/2022 |
| Certification Date | 11/29/2022 |
| Medicare PECOS PAC ID | 2365691474 |
|---|---|
| Medicare Enrollment ID | O20121005000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538424072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Subroto Kundu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063426302 PECOS PAC ID: 3274673629 Enrollment ID: I20091216000473 |
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