Provider Demographics
NPI:1811035371
Name:CHHABRA, NITIN (MD)
Entity Type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:CHHABRA
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 1:1413 CHATTANOOGA AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2631
Mailing Address - Country:US
Mailing Address - Phone:706-279-2635
Mailing Address - Fax:706-279-2679
Practice Address - Street 1:4515 SOUTHLAKE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3317
Practice Address - Country:US
Practice Address - Phone:205-313-7246
Practice Address - Fax:205-939-1911
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1017207L00000X
GA908782081P2900X
ALMD.29480207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I031521Medicare PIN