MEDICARE: MRS. AJIT K CHADHA 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	208D00000X	General Practice Physician	04373	RI

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	:	1407862980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AJIT K CHADHA MD

Provider Business Mailing Address
First Line	:	1312 OAKLAWN AVE
Second Line	:	MIDLAND MEDICAL
City	:	CRANSTON
State	:	RI
Zip	:	02920
Country	:	US
Telephone Number	:	401-463-3380
Fax Number	:	401-463-3308

Provider Business Practice Location Address
First Line	:	1312 OAKLAWN AVE
Second Line	:	MIDLAND MEDICAL
City	:	CRANSTON
State	:	RI
Zip	:	02920
Country	:	US
Telephone Number	:	401-463-3380
Fax Number	:	401-463-3308

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/09/2007

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