Provider Demographics
NPI:1124442017
Name:PUNCH, CHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:
Last Name:PUNCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:CO
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:314-590-7128
Mailing Address - Fax:
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:CO
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:314-590-7128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29026207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology