Provider Demographics
NPI:1417479593
Name:PARUL CHANDRIKA, FNU (MD)
Entity Type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:PARUL CHANDRIKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PARUL
Other - Middle Name:
Other - Last Name:CHANDRIKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4240 ALTAMONT PLACE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695
Mailing Address - Country:US
Mailing Address - Phone:240-518-6030
Mailing Address - Fax:240-518-6031
Practice Address - Street 1:4240 ALTAMONT PLACE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695
Practice Address - Country:US
Practice Address - Phone:240-518-6030
Practice Address - Fax:240-518-6031
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-03237207R00000X
MDD97765207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD219958100Medicaid