Provider Demographics
NPI:1144386921
Name:ASHOK CHADDAH MD LLC
Entity Type:Organization
Organization Name:ASHOK CHADDAH MD LLC
Other - Org Name:ASHOK CHADDAH MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADDAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-349-8636
Mailing Address - Street 1:841 HOSPITAL ROAD
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3659
Mailing Address - Country:US
Mailing Address - Phone:724-349-8636
Mailing Address - Fax:724-465-1022
Practice Address - Street 1:841 HOSPITAL ROAD
Practice Address - Street 2:SUITE 3500
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3659
Practice Address - Country:US
Practice Address - Phone:724-349-8636
Practice Address - Fax:724-465-4087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029372E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01140525Medicaid
E64094Medicare UPIN
PA01140525Medicaid