Provider Demographics
NPI:1306359872
Name:BALBIR S CHAUHAN MD
Entity Type:Organization
Organization Name:BALBIR S CHAUHAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALBIR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-679-2122
Mailing Address - Street 1:413 PULASKI HWY STE 204
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3625
Mailing Address - Country:US
Mailing Address - Phone:410-679-2122
Mailing Address - Fax:410-679-3065
Practice Address - Street 1:413 PULASKI HWY STE 204
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3625
Practice Address - Country:US
Practice Address - Phone:410-679-2122
Practice Address - Fax:410-679-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025032261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD255221300Medicaid