Provider Demographics
NPI:1609839265
Name:CHADHA, MOHINDER SINGH (MD)
Entity Type:Individual
Prefix:
First Name:MOHINDER
Middle Name:SINGH
Last Name:CHADHA
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 1:3170 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2945
Mailing Address - Country:US
Mailing Address - Phone:419-534-3500
Mailing Address - Fax:419-534-2608
Practice Address - Street 1:2142 N COVE BLVD
Practice Address - Street 2:CLM PATHOLOGY
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3895
Practice Address - Country:US
Practice Address - Phone:419-534-3500
Practice Address - Fax:419-534-2608
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080864207ZP0102X
MI4301037626207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI220003082OtherRRMC
OH220003082OtherRR MCR
OH000000544584OtherANTHEM-OH
OH2778605Medicaid
MI5206062Medicaid
MI2204600311OtherBCBS-MI
OH2778605Medicaid
MIP47200002Medicare PIN