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General NPI Number Information
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NPI Number | 1184708935
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Entity Type | Organization
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Legal Business Name | SPECIALISTS IN PRIMARY HEALTHCARE INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 5030 MASON CORBIN CT SUITE A
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City | FORT MYERS
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State | FL
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Zip | 33907-4541
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Country | US
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Telephone | 239-278-0330
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Fax | 239-278-1348
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Provider Business Mailing Address
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Address Line | 5030 MASON CORBIN CT SUITE B
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City | FORT MYERS
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State | FL
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Zip | 33907-4548
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Country | US
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Telephone | 239-278-0330
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Fax | 239-278-1348
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Authorized Official
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Title or Position | PRESIDENT
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Name | TEJVIR S CHADHA
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Credential | MD
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Telephone | 239-278-0330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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