Provider Demographics
NPI:1679851422
Name:CHAHAL, KASHIF ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHIF
Middle Name:ALI
Last Name:CHAHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:FAMILY MEDICINE RESIDENCY PROGRAM
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-867-0749
Mailing Address - Fax:
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:FAMILY MEDICINE RESIDENCY PROGRAM
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-887-3381
Practice Address - Fax:570-887-2807
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
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Provider Licenses
StateLicense IDTaxonomies
PAMT199677207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine