Provider Demographics
NPI:1497757553
Name:CHAUHAN, HITENDRA (MD)
Entity Type:Individual
Prefix:
First Name:HITENDRA
Middle Name:
Last Name:CHAUHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 MESQUITE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5771
Mailing Address - Country:US
Mailing Address - Phone:928-854-0060
Mailing Address - Fax:877-264-7602
Practice Address - Street 1:1840 MESQUITE AVE
Practice Address - Street 2:STE. B
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5771
Practice Address - Country:US
Practice Address - Phone:928-453-8500
Practice Address - Fax:928-453-3660
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24680174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ100009002OtherRAILROAD MEDICARE
AZ1198420002Medicare NSC
AZZWCJCW05Medicare PIN