Provider Demographics
NPI:1003079773
Name:CHABRA, INDERJIT (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:INDERJIT
Middle Name:
Last Name:CHABRA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:INDY
Other - Middle Name:
Other - Last Name:CHABRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:4715 E. CAMP LOWELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1256
Mailing Address - Country:US
Mailing Address - Phone:520-955-8395
Mailing Address - Fax:520-300-8013
Practice Address - Street 1:4715 E. CAMP LOWELL DRIVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-955-8395
Practice Address - Fax:520-300-8013
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8447207N00000X, 207ND0101X
IA40345207N00000X, 207ND0101X
NE27328207N00000X, 207ND0101X
AZ59743207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery