Provider Demographics
NPI:1124099429
Name:CHADDAH, ASHOK (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:CHADDAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 HOSPITAL RD
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3620
Mailing Address - Country:US
Mailing Address - Phone:724-349-8636
Mailing Address - Fax:724-465-1022
Practice Address - Street 1:841 HOSPITAL RD
Practice Address - Street 2:SUITE 3500
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3620
Practice Address - Country:US
Practice Address - Phone:724-349-8636
Practice Address - Fax:724-465-1022
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029372E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01140525Medicaid
PAE64094Medicare UPIN
PA01140525Medicaid