Provider Demographics
NPI:1811218456
Name:JEYACHANDRA BERRY, CHANDRA SINGH (MD,)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA SINGH
Middle Name:
Last Name:JEYACHANDRA BERRY
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:NATIONWIDE CHILDRENS HOSPITAL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2696
Practice Address - Country:US
Practice Address - Phone:614-722-6625
Practice Address - Fax:614-722-6627
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH81-0000972088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology