Provider Demographics
NPI:1356301261
Name:CHATTHA, JASWINDER K (MD)
Entity Type:Individual
Prefix:
First Name:JASWINDER
Middle Name:K
Last Name:CHATTHA
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 1:3200 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2363
Mailing Address - Country:US
Mailing Address - Phone:740-264-7751
Mailing Address - Fax:740-264-2422
Practice Address - Street 1:3200 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2363
Practice Address - Country:US
Practice Address - Phone:740-264-7751
Practice Address - Fax:740-264-2422
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0378332084P0800X
WV100702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0115310000Medicaid
OH0260293Medicaid
WV0115310000Medicaid
C03617Medicare UPIN
WVCH0409432Medicare ID - Type UnspecifiedWV MEDICARE