Provider Demographics
NPI:1730157637
Name:CHHATRE, MADHUKAR (MD)
Entity type:Individual
Prefix:
First Name:MADHUKAR
Middle Name:
Last Name:CHHATRE
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 1:3151 NE CARNEGIE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-3222
Mailing Address - Country:US
Mailing Address - Phone:816-347-0026
Mailing Address - Fax:816-347-1804
Practice Address - Street 1:3151 NE CARNEGIE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-3222
Practice Address - Country:US
Practice Address - Phone:816-347-0026
Practice Address - Fax:816-347-1804
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105416208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206747917Medicaid
MO240007511OtherRR MEDICARE
KS100147510BMedicaid
MOW033263Medicare PIN
MO206747917Medicaid