Healthcare Provider Details

I. General information

NPI: 1306461843
Provider Name (Legal Business Name): NIKITA CHHABRA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD # 3010
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

3621 S STATE ST
ANN ARBOR MI
48108-1633
US

V. Phone/Fax

Practice location:
  • Phone: 602-628-2944
  • Fax:
Mailing address:
  • Phone: 734-647-5299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number012444
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: