Provider Demographics
NPI:1699022426
Name:KASHYAP, CHANDRASHEKAR
Entity Type:Individual
Prefix:DR
First Name:CHANDRASHEKAR
Middle Name:
Last Name:KASHYAP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 JEFFERSON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1701
Mailing Address - Country:US
Mailing Address - Phone:706-227-4075
Mailing Address - Fax:
Practice Address - Street 1:5669 PEACHTREE DUNWOODY RD STE 240
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1719
Practice Address - Country:US
Practice Address - Phone:404-410-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA77635207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology