Mazumder, Chandan
Mazumder, Chandan is an sole proprietor health care provider with primary practice located at 1900 W Wall St Ste C , Midland TX 79701-6568. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mazumder, Chandan can be contacted via phone (432) 221-2500.Contact Information
Primary practice address
1900 W Wall St Ste C
Midland TX 79701-6568
Phone: (432) 221-2500
Fax: (432) 687-1914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME 98432 | Florida |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | P3771 | Texas |
Profile Details
| NPI number | 1093928913 |
|---|---|
| LBN Legal business name | Mazumder, Chandan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 7th, 2007 |
| Last updated | Jul 28th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093928913 | NPPES |
| Florida | MEDICAID | 279640600 | |
| Florida | MEDICAID | 305512101 |
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