Healthcare Provider Details

I. General information

NPI: 1154772168
Provider Name (Legal Business Name): SHERRY CHANDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2016
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N RIVERSIDE RD STE 200
SAINT JOSEPH MO
64507-2553
US

IV. Provider business mailing address

5301 FARAON ST STE 120
SAINT JOSEPH MO
64506-3512
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-8133
  • Fax: 816-271-8134
Mailing address:
  • Phone: 816-271-8133
  • Fax: 816-271-8134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT211833
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2021005809
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: