Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 25473 | AL |
Y | 207RP1001X | Pulmonary Disease | 25473 | AL |
N | 207RS0012X | Sleep Medicine | 25473 | AL |
NPI | 1003943556 |
---|---|
Provider Name | Dr. Kyathanahally M. Dinesh Chandra |
First Address | Tuscaloosa, AL 35401-2086 |
Second Address | Tuscaloosa, AL 35401-2086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 16/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H01710 | (02) | AL |