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General NPI Number Information
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NPI Number | 1487975223
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Entity Type | Individual
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Provider Name | DIVAY CHAUDHRY M.B.B.S
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Gender | Male
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 22 ROTH CHURCH RD
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City | SPRING GROVE
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State | PA
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Zip | 17362-1406
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Country | US
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Telephone | 717-757-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 22 ROTH CHURCH RD
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City | SPRING GROVE
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State | PA
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Zip | 17362-1406
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Country | US
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Telephone | 717-757-3400
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0078110
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD458549
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License Number State | PA
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