Healthcare Provider Details

I. General information

NPI: 1508886540
Provider Name (Legal Business Name): UDAY KUMAR PAYYADI CHANDRASHEKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 SAWGRASS DR
ADVANCE NC
27006-7583
US

IV. Provider business mailing address

122 SAWGRASS DR
ADVANCE NC
27006-7583
US

V. Phone/Fax

Practice location:
  • Phone: 908-429-5755
  • Fax: 586-446-9994
Mailing address:
  • Phone: 908-429-5755
  • Fax: 908-967-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA09557400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: