Provider Demographics
NPI:1316698897
Name:CHADDHER, ADIBA
Entity type:Individual
Prefix:MS
First Name:ADIBA
Middle Name:
Last Name:CHADDHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-2330
Mailing Address - Country:US
Mailing Address - Phone:317-536-5949
Mailing Address - Fax:
Practice Address - Street 1:224 E MONROE ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-2330
Practice Address - Country:US
Practice Address - Phone:317-536-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)