Provider Demographics
NPI:1730312224
Name:CHHEDA, GITESH DHIRAJ (MD)
Entity Type:Individual
Prefix:
First Name:GITESH
Middle Name:DHIRAJ
Last Name:CHHEDA
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 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:4021 AVENUE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4602
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO483802085R0202X
KS04-368112085R0202X
HIMD174512085R0202X
NE254862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025709000Medicaid
KS201141120AMedicaid
NE10026277400Medicaid
MT1730312224Medicaid
NE84089712600Medicaid
NE10026277300Medicaid
NM79481582Medicaid
NE84059792913Medicaid
NE10026277500Medicaid
NE10026277600Medicaid
NE10026277800Medicaid
NE10026277700Medicaid
IA1730312224Medicaid
WY1730312224Medicaid
NEP01558463Medicare PIN
KS111257062Medicare PIN
NE10026277500Medicaid
NE10026277600Medicaid
NE10026277800Medicaid
NE10026277300Medicaid
COP01019363Medicare PIN
NE10026277700Medicaid
NE84089712600Medicaid
COCO306837Medicare PIN
COP00992458Medicare PIN
KSKA3249023Medicare PIN
CO391183ZLJ3Medicare PIN