Healthcare Provider Details

I. General information

NPI: 1972979771
Provider Name (Legal Business Name): GAURAV CHAUHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2015
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD DEPT. OF ANESTHESIOLOGY, HENRY FORD HOSPITAL
DETROIT MI
48202-2608
US

IV. Provider business mailing address

1350 W BETHUNE ST APT. NO. 1607
DETROIT MI
48202-2600
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-8445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01092796A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101280406
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301108071
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number0101280406
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01092796A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: