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NPI Code Detail

MEDICARE: PAMELA G CHAWLA M.D.

MEDICARE: PAMELA G CHAWLA 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
1208000000XPediatrics Physician41278MN

Other Identifiers

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

General Provider Information

NPI Number : 1417956376
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA G CHAWLA M.D.
Provider Business Mailing Address
First Line : 2910 CENTRE POINT DR, 35-121A
Second Line : CHILDREN'S HEALTH CARE
City : ROSEVILLE
State : MN
Zip : 55113-1182
Country : US
Telephone Number : 651-855-2327
Fax Number : 651-855-2310
Provider Business Practice Location Address
First Line : 347 SMITH AVE N
Second Line : CHILDREN'S PRIMARY CLINIC - STPL
City : SAINT PAUL
State : MN
Zip : 55102-2387
Country : US
Telephone Number : 651-220-6789
Fax Number : 651-220-6807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 10/25/2012

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