Provider Demographics
NPI:1821215435
Name:MOHAN, CHANDRAMANI (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRAMANI
Middle Name:
Last Name:MOHAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 SILVER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4284
Mailing Address - Country:US
Mailing Address - Phone:586-500-9250
Mailing Address - Fax:586-500-9251
Practice Address - Street 1:35700 WARREN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3808
Practice Address - Country:US
Practice Address - Phone:586-500-9250
Practice Address - Fax:586-500-9251
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine