Provider Demographics
NPI:1902149446
Name:CHAND, ARCHANA (DO)
Entity Type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:CHAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ARCHANA
Other - Middle Name:
Other - Last Name:BHATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:170 TAYLOR STATION RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4491
Mailing Address - Country:US
Mailing Address - Phone:614-545-7900
Mailing Address - Fax:614-545-7901
Practice Address - Street 1:1087 DENNISON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3201
Practice Address - Country:US
Practice Address - Phone:877-749-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.013081208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0306664Medicaid