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General NPI Number Information
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NPI Number | 1740097567
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Entity Type | Organization
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Legal Business Name | AJAY CHAWLA MD LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 110 AUBURN AVE STE 2
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City | SHELBY
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State | OH
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Zip | 44875-1171
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Country | US
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Telephone | 419-342-4242
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Fax | 419-347-1873
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Provider Business Mailing Address
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Address Line | 110 AUBURN AVE STE 2
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City | SHELBY
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State | OH
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Zip | 44875-1171
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Country | US
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Telephone | 419-342-4242
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Fax | 419-347-1873
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Authorized Official
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Title or Position | OWNER
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Name | AJAY CHAWLA
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Credential | MD
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Telephone | 419-342-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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