Healthcare Provider Details

I. General information

NPI: 1730157637
Provider Name (Legal Business Name): MADHUKAR CHHATRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 NE CARNEGIE DR
LEES SUMMIT MO
64064-3222
US

IV. Provider business mailing address

3151 NE CARNEGIE DR
LEES SUMMIT MO
64064-3222
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-0026
  • Fax: 816-347-1804
Mailing address:
  • Phone: 816-347-0026
  • Fax: 816-347-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number105416
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: