Provider Demographics
NPI:1336178680
Name:CHAWLA, SURENDRA SINGH (MD)
Entity type:Individual
Prefix:
First Name:SURENDRA
Middle Name:SINGH
Last Name:CHAWLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:274 MAIN ST
Mailing Address - Street 2:SUITE# 308
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3611
Mailing Address - Country:US
Mailing Address - Phone:781-944-8950
Mailing Address - Fax:781-944-8977
Practice Address - Street 1:274 MAIN ST
Practice Address - Street 2:SUITE # 308
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3611
Practice Address - Country:US
Practice Address - Phone:781-944-8950
Practice Address - Fax:781-944-8977
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA49825207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6177719Medicaid
MA1336178680Medicare PIN
MA6177719Medicaid