Provider Demographics
NPI:1275593873
Name:CHANDNANI, VIJAY P (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:P
Last Name:CHANDNANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:471 E BROAD ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3842
Mailing Address - Country:US
Mailing Address - Phone:614-221-3303
Mailing Address - Fax:614-464-2281
Practice Address - Street 1:111 S GRANT AVE
Practice Address - Street 2:3RD FLOOR RADIOLOGY
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4701
Practice Address - Country:US
Practice Address - Phone:614-566-9231
Practice Address - Fax:614-566-8385
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-2806-C2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2113573Medicaid
OHE84936Medicare UPIN
OHCH0876431Medicare ID - Type Unspecified