Provider Demographics
NPI:1679781488
Name:SUNIL G. NILIMA P, CHAND PARTNERSHIP
Entity Type:Organization
Organization Name:SUNIL G. NILIMA P, CHAND PARTNERSHIP
Other - Org Name:PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-756-7880
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-0749
Mailing Address - Country:US
Mailing Address - Phone:573-756-7880
Mailing Address - Fax:573-756-2669
Practice Address - Street 1:1035 E KARSCH BLVD
Practice Address - Street 2:STE B
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-3404
Practice Address - Country:US
Practice Address - Phone:573-756-7880
Practice Address - Fax:573-756-2669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007006310174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF9313Medicare PIN