Provider Demographics
NPI:1508868332
Name:CHAHAL, BHUPINDER SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:BHUPINDER
Middle Name:SINGH
Last Name:CHAHAL
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 1:6800 W CENTRAL AVE
Mailing Address - Street 2:SUITE D-3
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1135
Mailing Address - Country:US
Mailing Address - Phone:419-841-1355
Mailing Address - Fax:419-843-8048
Practice Address - Street 1:6800 W CENTRAL AVE
Practice Address - Street 2:SUITE D-3
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1135
Practice Address - Country:US
Practice Address - Phone:419-841-1355
Practice Address - Fax:419-843-8048
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-87192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0552950Medicaid
9295971Medicare PIN
OHA15675Medicare UPIN
2005901Medicare PIN
OH0552950Medicaid