Healthcare Provider Details

I. General information

NPI: 1427395763
Provider Name (Legal Business Name): MONIKA CHAUHAN MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN ST
DETROIT MI
48201-2119
US

IV. Provider business mailing address

2043 N LOVINGTON DR APT 204
TROY MI
48083-4381
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-0122
  • Fax:
Mailing address:
  • Phone: 646-330-9744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301095900
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number4301095900
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: