Provider Demographics
NPI:1619953700
Name:CHANI, SWARANJIT K (MD)
Entity Type:Individual
Prefix:DR
First Name:SWARANJIT
Middle Name:K
Last Name:CHANI
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 1:150 S HEWITT RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-8803
Mailing Address - Country:US
Mailing Address - Phone:270-843-1037
Mailing Address - Fax:
Practice Address - Street 1:207 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1114
Practice Address - Country:US
Practice Address - Phone:270-786-2372
Practice Address - Fax:270-786-2472
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33125207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64331259Medicaid
KY33125OtherSTATE ID
KY33125OtherSTATE ID
KY0797601Medicare PIN