Provider Demographics
NPI:1407862980
Name:CHADHA, AJIT K (MD)
Entity type:Individual
Prefix:MRS
First Name:AJIT
Middle Name:K
Last Name:CHADHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1312 OAKLAWN AVE
Mailing Address - Street 2:MIDLAND MEDICAL
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920
Mailing Address - Country:US
Mailing Address - Phone:401-463-3380
Mailing Address - Fax:401-463-3308
Practice Address - Street 1:1312 OAKLAWN AVE
Practice Address - Street 2:MIDLAND MEDICAL
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-463-3380
Practice Address - Fax:401-463-3308
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI04373208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7004785Medicaid
D27199Medicare UPIN