Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 33027 | NE |
NPI | 1063942464 |
---|---|
Provider Name | Dr. Chandrakumaran Anchalia |
First Address | Grand Island, NE 68803 |
Second Address | Grand Island, NE 68803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2017 |
Last Update Date | 29/07/2021 |