Provider Demographics
NPI:1821570516
Name:CHANDRA, SAMIRA ZANNAT (MBBS)
Entity type:Individual
Prefix:DR
First Name:SAMIRA
Middle Name:ZANNAT
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 KANIS RD APT 525
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4955
Mailing Address - Country:US
Mailing Address - Phone:574-387-8684
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # 44195000
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-2905
Practice Address - Country:US
Practice Address - Phone:574-387-8684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1821570516207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1821570516OtherRESIDENT IN THE ORGANIZATION
OH1821570516OtherASSOCIATE STAFF PHYSICIAN IN THE ORGANIZATION