Provider Demographics
NPI:1659559417
Name:CHATUR J BABARIA MD PC
Entity Type:Organization
Organization Name:CHATUR J BABARIA MD PC
Other - Org Name:QUEEN CREEK FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHATUR
Authorized Official - Middle Name:J
Authorized Official - Last Name:BABARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-677-3494
Mailing Address - Street 1:22707 S ELLSWORTH RD
Mailing Address - Street 2:STE H-103
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6131
Mailing Address - Country:US
Mailing Address - Phone:480-677-3494
Mailing Address - Fax:480-677-4319
Practice Address - Street 1:22707 S ELLSWORTH RD
Practice Address - Street 2:STE H-103
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6131
Practice Address - Country:US
Practice Address - Phone:480-677-3494
Practice Address - Fax:480-677-4319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty