MEDICARE: TEJVIR S 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	207R00000X	Internal Medicine Physician	ME36582	FL

General Provider Information

NPI Number	:	1457311342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEJVIR S CHADHA MD

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE FL 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	5030 MASON CORBIN CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-4548
Country	:	US
Telephone Number	:	239-278-0330
Fax Number	:	239-278-1345

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	02/06/2024

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