MEDICARE: KETAN CHHAGAN DALSANIA DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	287	AL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	POD001033	GA

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	:	1891794459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KETAN CHHAGAN DALSANIA DPM

Provider Business Mailing Address
First Line	:	705 17TH ST
Second Line	:	STE 200
City	:	COLUMBUS
State	:	GA
Zip	:	31901-3507
Country	:	US
Telephone Number	:	706-322-7884
Fax Number	:	706-660-2142

Provider Business Practice Location Address
First Line	:	2300 MANCHESTER EXPY STE 101A
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6802
Country	:	US
Telephone Number	:	706-322-6646
Fax Number	:	706-322-2891

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

Provider Enumeration Date	:	07/17/2005
Last Update Date	:	12/15/2025

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