Provider Demographics
NPI:1093980518
Name:KACHHADIYA, GOVINDBHAI PARSHOTTAMBHAI (MD)
Entity Type:Individual
Prefix:
First Name:GOVINDBHAI
Middle Name:PARSHOTTAMBHAI
Last Name:KACHHADIYA
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-4740
Mailing Address - Fax:717-738-6872
Practice Address - Street 1:169 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1724
Practice Address - Country:US
Practice Address - Phone:717-721-8195
Practice Address - Fax:717-733-6010
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440887207Q00000X, 208M00000X
IN01063004A208D00000X
NY247133208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013977730026Medicaid
PA190001VOUOtherMEDICARE
PA190001YEBK - 213827Medicare PIN