Provider Demographics
NPI:1083968713
Name:CHANDER MOHAN, M.D., INC.
Entity Type:Organization
Organization Name:CHANDER MOHAN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-929-9794
Mailing Address - Street 1:275 GRAHAM RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2203
Mailing Address - Country:US
Mailing Address - Phone:330-929-9794
Mailing Address - Fax:330-929-9850
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:SUITE 5
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2203
Practice Address - Country:US
Practice Address - Phone:330-929-9794
Practice Address - Fax:330-929-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH649172084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0107324Medicaid
0741324Medicare PIN