Provider Demographics
NPI:1467715946
Name:CHHEDA, JAYANT MANILAL
Entity Type:Individual
Prefix:MR
First Name:JAYANT
Middle Name:MANILAL
Last Name:CHHEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7485 ELMBURY CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8327
Mailing Address - Country:US
Mailing Address - Phone:317-345-4229
Mailing Address - Fax:
Practice Address - Street 1:2394 25TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3719
Practice Address - Country:US
Practice Address - Phone:812-372-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022200A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist