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General NPI Number Information
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NPI Number | 1750349874
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Entity Type | Individual
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Provider Name | RAM CHANDRA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 408 N 4TH ST STE B
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City | ODESSA
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State | MO
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Zip | 64076-1646
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Country | US
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Telephone | 816-633-1630
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Fax | 816-633-1637
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Provider Business Mailing Address
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Address Line | 408 N 4TH ST STE B
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City | ODESSA
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State | MO
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Zip | 64076-1646
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Country | US
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Telephone | 816-633-1630
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Fax | 816-633-1637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 105321
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 105321
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License Number State | MO
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