Physician Compare National (NPI:1760534275)

HEALTHCARE PROVIDER: CHANDROTH VELANDY PURUSHOTHAMAN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1760534275
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1456515923
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120613000205
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PURUSHOTHAMAN
	Individual professional last name
Provider First Name	CHANDROTH
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1966
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	212 PENNY LN
	Group Practice or individual's line 1 address
City	MOREHEAD CITY
	Group Practice or individual's city
State	NC
	Group Practice or individual's state
Zip Code	285574305
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	340142
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CARTERET GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y