Provider Demographics
NPI:1578511598
Name:CHANDER, RAVI S (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:S
Last Name:CHANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-0128
Mailing Address - Country:US
Mailing Address - Phone:423-661-8707
Mailing Address - Fax:423-661-8779
Practice Address - Street 1:7425 ZIEGLER ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2136
Practice Address - Country:US
Practice Address - Phone:423-661-8707
Practice Address - Fax:423-661-8779
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN310422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38322371Medicare PIN
GA13BDDSMMedicare PIN
TNG60764Medicare UPIN