Provider Demographics
NPI:1154772168
Name:CHANDY, SHERRY (MD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:CHANDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 FARAON ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3512
Mailing Address - Country:US
Mailing Address - Phone:816-271-8133
Mailing Address - Fax:816-271-8134
Practice Address - Street 1:802 N RIVERSIDE RD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2553
Practice Address - Country:US
Practice Address - Phone:816-271-8133
Practice Address - Fax:816-271-8134
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211833390200000X
MO20210058092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program