Provider Demographics
NPI:1386130060
Name:RAVI CHANDAR, MARIE CHRISTIANNE SANDHYA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE CHRISTIANNE
Middle Name:SANDHYA
Last Name:RAVI CHANDAR
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 1:1616 W GERMANN RD APT 2044
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-6986
Mailing Address - Country:US
Mailing Address - Phone:216-767-3184
Mailing Address - Fax:
Practice Address - Street 1:17900 N PORTER RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-4228
Practice Address - Country:US
Practice Address - Phone:520-233-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ62243208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics