MEDICARE: UDAY CHAUHAN MD PA

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	ME73576	FL

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	:	1790814770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UDAY CHAUHAN MD PA

Provider Business Mailing Address
First Line	:	2720 REBECCA LN
Second Line	:	SUITE 101
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8351
Country	:	US
Telephone Number	:	386-456-5159
Fax Number	:	386-456-0139

Provider Business Practice Location Address
First Line	:	2720 REBECCA LN
Second Line	:	SUITE 101
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8351
Country	:	US
Telephone Number	:	386-456-5159
Fax Number	:	386-456-0139

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. UDAY CHAUHAN
Credential	:	MD
Telephone Number	:	386-456-5159

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	08/22/2020

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