Healthcare Provider Details
I. General information
NPI: 1376985978
Provider Name (Legal Business Name): SURMEET SINGH CHHINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/24/2013
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
175 MADISON AVE FL 1
MOUNT HOLLY NJ
08060-2099
US
IV. Provider business mailing address
301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US
V. Phone/Fax
- Phone: 609-914-6000
- Fax:
- Phone: 856-355-0340
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 25MA12133300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | MD480492 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | MT205062 |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | MT205062 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: