Healthcare Provider Details

I. General information

NPI: 1275583585
Provider Name (Legal Business Name): CHANDAR RAJA ABBOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 OWEN DR
FAYETTEVILLE NC
28304-3424
US

IV. Provider business mailing address

151 HAROLD FLEMING COURT
SPARTANBURG SC
29303-4225
US

V. Phone/Fax

Practice location:
  • Phone: 910-615-7392
  • Fax:
Mailing address:
  • Phone: 864-573-6320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number31600
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2011-01582
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number31600
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2011-01582
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: