Healthcare Provider Details

I. General information

NPI: 1124055082
Provider Name (Legal Business Name): NAMARTA AWASTHI CHANDRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MINNESOTA PHYSICIANS 516 DELAWARE STREET SE, PWB FIRST FLOOR, CLINIC 1D
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE STREET SE, MMC 292
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-0622
  • Fax: 612-273-2696
Mailing address:
  • Phone: 612-626-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number41453
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number41453
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: