Provider Demographics
NPI:1578948956
Name:CHANDRAN, ASWATHI (MD)
Entity Type:Individual
Prefix:
First Name:ASWATHI
Middle Name:
Last Name:CHANDRAN
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 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-393-4892
Mailing Address - Fax:270-780-0475
Practice Address - Street 1:484 GOLDEN AUTUMN WAY STE 201
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-6914
Practice Address - Country:US
Practice Address - Phone:270-393-4892
Practice Address - Fax:270-780-0475
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54879207RG0100X
IL125066675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine