Healthcare Provider Details

I. General information

NPI: 1427695287
Provider Name (Legal Business Name): DAVINDERJIT KAUR CHAHAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2019
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 S LIVERNOIS RD
ROCHESTER HILLS MI
48307-6901
US

IV. Provider business mailing address

65 S LIVERNOIS RD
ROCHESTER HILLS MI
48307-6901
US

V. Phone/Fax

Practice location:
  • Phone: 248-652-4700
  • Fax: 248-652-1961
Mailing address:
  • Phone: 248-652-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302034372
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: