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NPI Code Detail

MEDICARE: DR. PRADEEP AARON CHANDRA D.O.

MEDICARE: DR. PRADEEP AARON CHANDRA D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician036134914IL
2207RC0000XCardiovascular Disease Physician2008032065MO

General Provider Information

NPI Number : 1124225347
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRADEEP AARON CHANDRA D.O.
Provider Business Mailing Address
First Line : 3550 MCKELVEY RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2527
Country : US
Telephone Number : 147-410-9113
Fax Number : 314-218-9622
Provider Business Practice Location Address
First Line : 3550 MCKELVEY RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2527
Country : US
Telephone Number : 147-410-9113
Fax Number : 314-218-9622
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 08/21/2025

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