Healthcare Provider Details

I. General information

NPI: 1144386921
Provider Name (Legal Business Name): ASHOK CHADDAH MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 HOSPITAL ROAD SUITE 3500
INDIANA PA
15701-3659
US

IV. Provider business mailing address

841 HOSPITAL ROAD SUITE 3500
INDIANA PA
15701-3659
US

V. Phone/Fax

Practice location:
  • Phone: 724-349-8636
  • Fax: 724-465-4087
Mailing address:
  • Phone: 724-349-8636
  • Fax: 724-465-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD029372E
License Number StatePA

VIII. Authorized Official

Name: ASHOK CHADDAH
Title or Position: PRESIDENT
Credential: MD
Phone: 724-349-8636