Provider Demographics
NPI:1194138958
Name:CHAHAL, KHUSHMINDER SINGH (MD)
Entity type:Individual
Prefix:MR
First Name:KHUSHMINDER
Middle Name:SINGH
Last Name:CHAHAL
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 1:2027N LOVINGTON DR 106
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4374
Mailing Address - Country:CA
Mailing Address - Phone:313-455-1370
Mailing Address - Fax:
Practice Address - Street 1:3901 CHRYSLER SERVICE DRIVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207
Practice Address - Country:US
Practice Address - Phone:313-577-7523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2015-12-23
Deactivation Date:2015-01-14
Deactivation Code:
Reactivation Date:2015-02-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program