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General NPI Number Information
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NPI Number | 1689958803
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Entity Type | Organization
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Legal Business Name | ADVANCED CENTER FOR SLEEP DISORDERS
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 1411 CHATTANOOGA AVE SUITE 102
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City | DALTON
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State | GA
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Zip | 30720-2673
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Country | US
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Telephone | 423-648-8008
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Fax | 706-657-4400
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Provider Business Mailing Address
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Address Line | 6073 E BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3909
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Country | US
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Telephone | 423-648-8008
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Fax | 706-657-4400
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | ANUJ CHANDRA
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Credential | M.D.
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Telephone | 423-648-8008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 248184
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License Number State | GA
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