Provider Demographics
NPI:1770717076
Name:JEYARAM, CHELLAPANDIAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHELLAPANDIAN
Middle Name:
Last Name:JEYARAM
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 1:19 MERRYTON ST
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4332
Mailing Address - Country:US
Mailing Address - Phone:856-784-7224
Mailing Address - Fax:856-784-7224
Practice Address - Street 1:19 MERRYTON ST
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4332
Practice Address - Country:US
Practice Address - Phone:856-784-7224
Practice Address - Fax:856-784-7224
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02840100207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology