MEDICARE: DR. AMRITA CHADHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2003-0574	NM
2	207L00000X	Anesthesiology Physician	35.091999	OH
3	207LA0401X	Addiction Medicine (Anesthesiology) Physician	35.091999	OH
4	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	35.091999	OH
5	207LH0002X	Hospice and Palliative Medicine (Anesthesiology) Physician	35.091999	OH
6	207LP2900X	Pain Medicine (Anesthesiology) Physician	35.091999	OH
7	207LP3000X	Pediatric Anesthesiology Physician	35.091999	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093767188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMRITA CHADHA M.D.

Provider Business Mailing Address
First Line	:	24701 EUCLID AVE
Second Line	:	3RD FLOOR
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:	216-383-6616
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-844-7330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	08/17/2010

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