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General NPI Number Information
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NPI Number | 1437563657
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Entity Type | Individual
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Provider Name | RAJ KIRAN CHAWLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 3365 S 103RD ST STE 210
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City | MILWAUKEE
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State | WI
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Zip | 53227-4161
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Country | US
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Telephone | 262-814-7080
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Fax | 262-432-9004
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Provider Business Mailing Address
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Address Line | 9000 W WISCONSIN AVE # MS 958
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone | 414-266-7451
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Fax | 414-266-6238
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10050944
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 67325
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License Number State | WI
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