Provider Demographics
NPI:1164478129
Name:CHAWLA, RAVJYOT (MD)
Entity Type:Individual
Prefix:
First Name:RAVJYOT
Middle Name:
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 GOOD LUCK RD STE 305
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3508
Mailing Address - Country:US
Mailing Address - Phone:301-552-1200
Mailing Address - Fax:301-552-1202
Practice Address - Street 1:8116 GOOD LUCK RD STE 305
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3508
Practice Address - Country:US
Practice Address - Phone:301-552-1200
Practice Address - Fax:301-552-1202
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036005207RC0000X
VA0101253293207RC0000X
MDD0064319207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018337701Medicaid
DC038235500Medicaid