Provider Demographics
NPI:1457928046
Name:CHAND, VASUNDHRA RAJE (NMD)
Entity Type:Individual
Prefix:DR
First Name:VASUNDHRA
Middle Name:RAJE
Last Name:CHAND
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 W COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-6643
Mailing Address - Country:US
Mailing Address - Phone:425-301-9151
Mailing Address - Fax:
Practice Address - Street 1:1107 S BEELINE HWY STE 2
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5486
Practice Address - Country:US
Practice Address - Phone:928-363-1417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21-19542083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine