| Organization Name: | V. RAJA CHANDRA, MD PC |
| NPI Number: | 1043548019 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VENKATAPERUMAL R CHANDRASEKARAN (OWNER) |
| Mailing Address: | 519 8th St Rawlins |
| State: | WY US |
| Postal Code: | 823015460 |
| Phone Number: | 3073242294 |
| Fax Number: | 3073281964 |
| NPI Enumeration Date: | 12/02/2009 |
| NPI Last Update Date: | 12/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 2812A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |