1821570516 NPI number — DR. SAMIRA ZANNAT CHANDRA MBBS

Table of content: DR. SAMIRA ZANNAT CHANDRA MBBS (NPI 1821570516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821570516 NPI number — DR. SAMIRA ZANNAT CHANDRA MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANDRA
Provider First Name:
SAMIRA
Provider Middle Name:
ZANNAT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBBS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821570516
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14201 KANIS RD APT 525
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72223-4955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
574-387-8684
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 EUCLID AVE # 44195000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-387-8684
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  1821570516 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1821570516 . This is a "RESIDENT IN THE ORGANIZATION" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1821570516 . This is a "ASSOCIATE STAFF PHYSICIAN IN THE ORGANIZATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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