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General NPI Number Information
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NPI Number | 1427120187
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Entity Type | Organization
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Legal Business Name | SUNIL G & NILIMA P CHAND
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 04/22/2010
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Provider Practice Location Address
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Address Line | 1031 E KARSCH BLVD
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City | FARMINGTON
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State | MO
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Zip | 63640-3404
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Country | US
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Telephone | 573-756-7880
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Fax | 573-756-2669
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Provider Business Mailing Address
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Address Line | PO BOX 107
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City | FARMINGTON
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State | MO
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Zip | 63640-0107
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Country | US
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Telephone | 573-756-7880
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Fax | 573-756-2669
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Authorized Official
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Title or Position | PARTNER
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Name | SUNIL GUPTA CHAND
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Credential | M.D.
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Telephone | 573-756-7880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 109268
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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