Provider Demographics
NPI:1205839024
Name:CHAND, ERIC M (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:CHAND
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 1:2401 WILLOW DROP WAY
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-7085
Mailing Address - Country:US
Mailing Address - Phone:912-515-5748
Mailing Address - Fax:407-890-2177
Practice Address - Street 1:8300 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6801
Practice Address - Country:US
Practice Address - Phone:407-890-2179
Practice Address - Fax:407-890-2181
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00024997207ZP0102X
GA051124207ZP0102X
TNMD0000036998207ZP0102X
FLME126864207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA114096611AMedicaid
AL009980615Medicaid
TN3831539Medicare PIN
I05649Medicare UPIN
GA22BDDNPMedicare ID - Type UnspecifiedMEDICARE PROVIDER #
GA114096611AMedicaid