Provider Demographics
NPI:1124765524
Name:SOMWARU, CHANDRA D
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:D
Last Name:SOMWARU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 LOCHS LN
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-6812
Mailing Address - Country:US
Mailing Address - Phone:330-241-3941
Mailing Address - Fax:
Practice Address - Street 1:4404 LOCHS LN
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-6812
Practice Address - Country:US
Practice Address - Phone:330-241-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide