Basic Information
Provider Information
NPI: 1760566855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEESAM
FirstName: CHANDRA SHEKHAR
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HYGEIA DR
Address2: CCHS INC., SUITE 2502 PHYSICIAN CONTRACTING
City: NEWARK
State: DE
PostalCode: 197132049
CountryCode: US
TelephoneNumber: 3026237362
FaxNumber: 3026237374
Practice Location
Address1: 4735 OGLETOWN STANTON RD
Address2: MAP 2, SUITE 1201& 1205
City: NEWARK
State: DE
PostalCode: 197132072
CountryCode: US
TelephoneNumber: 3027331980
FaxNumber: 3027331986
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 06/19/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000XC10003707DEY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

No ID Information.


Home