Provider Demographics
NPI:1114991536
Name:VARIA, CHANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:
Last Name:VARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11021 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:KY
Mailing Address - Zip Code:41649-7999
Mailing Address - Country:US
Mailing Address - Phone:606-285-9221
Mailing Address - Fax:606-285-6428
Practice Address - Street 1:11021 MAIN ST
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:KY
Practice Address - Zip Code:41649-7999
Practice Address - Country:US
Practice Address - Phone:606-285-9221
Practice Address - Fax:606-285-6428
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20525207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64205255Medicaid
KYD47497Medicare UPIN
KY1422701Medicare ID - Type Unspecified