MEDICARE: DR. NATHAN C CHANDLER M.D., M.B.A.

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
1	2085R0202X	Diagnostic Radiology Physician	ME 90517	FL
2	2085R0202X	Diagnostic Radiology Physician	M9203	TX

General Provider Information

NPI Number	:	1144211244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN C CHANDLER M.D., M.B.A.

Provider Business Mailing Address
First Line	:	5744 DIAMOND POINT CIR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4158
Country	:	US
Telephone Number	:	915-569-1752
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 NORTH PIEDRAS ST
Second Line	:	DEPARTMENT OF RADIOLOGY, WBAMC
City	:	EL PASO
State	:	TX
Zip	:	79920-5001
Country	:	US
Telephone Number	:	915-569-1752
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	02/05/2009

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