Provider Demographics
NPI:1891016119
Name:CHANDRA, SMITHA ACHUTHANKUTTY (MD)
Entity Type:Individual
Prefix:DR
First Name:SMITHA
Middle Name:ACHUTHANKUTTY
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SMITHA
Other - Middle Name:
Other - Last Name:ACHUTHANKUTTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6356 TARTON FIELDS LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8341
Mailing Address - Country:US
Mailing Address - Phone:716-525-0496
Mailing Address - Fax:513-215-1974
Practice Address - Street 1:3300 MERCY HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1103
Practice Address - Country:US
Practice Address - Phone:513-215-0340
Practice Address - Fax:513-215-1974
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.121887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine