Provider Demographics
NPI:1851377196
Name:CHAND, MRIDU S (MD)
Entity Type:Individual
Prefix:
First Name:MRIDU
Middle Name:S
Last Name:CHAND
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:PO BOX 117287
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7287
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:551 BREVARD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2316
Practice Address - Country:US
Practice Address - Phone:828-212-7021
Practice Address - Fax:828-232-8218
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201057207RH0000X, 207RX0202X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD6225OtherMEDCOST
NC2029225BOtherMEDICARE - SYLVA
NC2029225COtherMEDICARE -- BREVARD
NC89137HWMedicaid
NC2029225AOtherMEDICARE - ASHEVILLE
NCP00430819OtherMEDICARE RAILROAD
NC137HWOtherBCBSNC
NC2029225AOtherMEDICARE - ASHEVILLE
NCD6225OtherMEDCOST
G67454Medicare UPIN