Provider Demographics
NPI:1689926214
Name:CHAWLA, SUDEEP (DC)
Entity Type:Individual
Prefix:DR
First Name:SUDEEP
Middle Name:
Last Name:CHAWLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3379
Mailing Address - Country:US
Mailing Address - Phone:517-420-2435
Mailing Address - Fax:978-208-0494
Practice Address - Street 1:435 NEWBURY ST STE 208
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1065
Practice Address - Country:US
Practice Address - Phone:617-334-5002
Practice Address - Fax:978-208-0494
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-10718111N00000X
MA3585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor