Healthcare Provider Details

I. General information

NPI: 1851378103
Provider Name (Legal Business Name): AMARDEEP S CHAUHAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7442 FRANK AVE NW
NORTH CANTON OH
44720-7022
US

IV. Provider business mailing address

7442 FRANK AVE NW
NORTH CANTON OH
44720-7022
US

V. Phone/Fax

Practice location:
  • Phone: 330-305-0838
  • Fax: 330-491-2048
Mailing address:
  • Phone: 330-305-0838
  • Fax: 330-491-2048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number34.006554
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: