Healthcare Provider Details

I. General information

NPI: 1770561920
Provider Name (Legal Business Name): CHANDRAKUMAR SINGARAYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-5111
US

IV. Provider business mailing address

PO BOX 2540
NORTH CONWAY NH
03860-2540
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-5462
  • Fax:
Mailing address:
  • Phone: 603-356-5472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number10694
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: