Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 04-33682 | KS |
N | 207RC0000X | Internist - Cardiovascular Disease | 24539 | OK |
N | 207RC0000X | Internist - Cardiovascular Disease | KSDEA-FV1379646 | KS |
N | 207RC0000X | Internist - Cardiovascular Disease | MO-2009008971 | MO |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 04-33682 | KS |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 2009008971 | MO |
NPI | 1265572481 |
---|---|
Provider Name | Dr. Chandrasekhar R Vasamreddy |
First Address | Overland Park, KS 66209-3721 |
Second Address | Overland Park, KS 66209-3721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265572481 | (05) | MO |
200611200A | (05) | KS |
450A00003A | MEDICARE JACKSON COUNTY (01) | MO |
450D00003D | MEDICARE JOHNSON COUNTY (01) | KS |
67A00005 | MEDICARE PTANK (01) | KS |
K67000014 | MEDICARE PTAN (01) | KS |