Provider Demographics
NPI:1699267385
Name:CHANDRAN, MANJU (MD)
Entity type:Individual
Prefix:
First Name:MANJU
Middle Name:
Last Name:CHANDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MANJU
Other - Middle Name:
Other - Last Name:GIRISH CHANDRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:740 S LIMESTONE STE L304
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE STE L304
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-6712
Practice Address - Country:US
Practice Address - Phone:859-323-3900
Practice Address - Fax:859-257-8138
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301114876207R00000X
KY60786207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine