MEDICARE: JAGDISH H KARAMCHANDANI MD LLC

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1790970911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAGDISH H KARAMCHANDANI MD LLC

Provider Business Mailing Address
First Line	:	540 BUCHANAN ST
Second Line	:	SUITE C
City	:	SANDUSKY
State	:	OH
Zip	:	44870-4749
Country	:	US
Telephone Number	:	419-621-8330
Fax Number	:	419-621-8325

Provider Business Practice Location Address
First Line	:	540 BUCHANAN ST
Second Line	:	SUITE C
City	:	SANDUSKY
State	:	OH
Zip	:	44870-4749
Country	:	US
Telephone Number	:	419-621-8330
Fax Number	:	419-621-8325

Authorized Official
Title or Position	:	OWNER
Name	:	JAGDISH H KARAMCHANDANI
Credential	:	M.D.
Telephone Number	:	419-621-8330

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	09/11/2007

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