MEDICARE: DR. CHANDRAMANI MOHAN M.D

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	207Q00000X	Family Medicine Physician	4301088844	MI

General Provider Information

NPI Number	:	1821215435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHANDRAMANI MOHAN M.D

Provider Business Mailing Address
First Line	:	1131 SILVER CREEK CT
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4284
Country	:	US
Telephone Number	:	586-500-9250
Fax Number	:	586-500-9251

Provider Business Practice Location Address
First Line	:	35700 WARREN RD
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-3808
Country	:	US
Telephone Number	:	586-500-9250
Fax Number	:	586-500-9251

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	03/31/2025

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