MEDICARE: BALBIR S CHAUHAN MD

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	261QP2300X	Primary Care Clinic/Center	D0025032	MD

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

General Provider Information

NPI Number	:	1306359872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALBIR S CHAUHAN MD

Provider Business Mailing Address
First Line	:	413 PULASKI HWY STE 204
Second Line	:
City	:	JOPPA
State	:	MD
Zip	:	21085-3625
Country	:	US
Telephone Number	:	410-679-2122
Fax Number	:	410-679-3065

Provider Business Practice Location Address
First Line	:	413 PULASKI HWY STE 204
Second Line	:
City	:	JOPPA
State	:	MD
Zip	:	21085-3625
Country	:	US
Telephone Number	:	410-679-2122
Fax Number	:	410-679-3065

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BALBIR SINGH CHAUHAN
Credential	:	MD
Telephone Number	:	410-679-2122

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	11/07/2017

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Directions to “BALBIR S CHAUHAN MD ” Practice Location

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