Provider Demographics
NPI:1124055082
Name:CHANDRA, NAMARTA AWASTHI (MD)
Entity type:Individual
Prefix:DR
First Name:NAMARTA
Middle Name:AWASTHI
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-3345
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:516 DELAWARE STREET SE, PWB FIRST FLOOR, CLINIC 1D
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-273-0622
Practice Address - Fax:612-273-2696
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN414532085B0100X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN16-02032OtherMEDICA PRIMARY
WI32602400Medicaid
IA0540666Medicaid
MN01021655OtherPREFERRED ONE
MN44R95CHOtherBCBS
MNHP38513OtherHEALTHPARTNERS
MN123842OtherUCARE
MN16-00419OtherMEDICA CHOICE
ND10387Medicaid
MN866695OtherARAZ
MN44R95CHOtherBCBS
MNH02542Medicare UPIN
MN16-02032OtherMEDICA PRIMARY
WI32602400Medicaid