MEDICARE: MAQSOODA CHANDANI BRYANT CNM

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	367A00000X	Advanced Practice Midwife	APRN.CNM.0019657	OH

General Provider Information

NPI Number	:	1679383715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAQSOODA CHANDANI BRYANT CNM

Provider Business Mailing Address
First Line	:	3831 W 133RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-4412
Country	:	US
Telephone Number	:	216-673-6598
Fax Number	:

Provider Business Practice Location Address
First Line	:	3831 W 133RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-4412
Country	:	US
Telephone Number	:	216-673-6598
Fax Number	:	216-279-5906

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

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	02/09/2026

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