Provider Demographics
NPI:1811220320
Name:CHAVDA, ROOPA K (MD)
Entity Type:Individual
Prefix:
First Name:ROOPA
Middle Name:K
Last Name:CHAVDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-2136
Mailing Address - Country:US
Mailing Address - Phone:216-342-4798
Mailing Address - Fax:
Practice Address - Street 1:10 SEVERANCE CIR
Practice Address - Street 2:KAISER PERMAMNENTE,
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1533
Practice Address - Country:US
Practice Address - Phone:216-524-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2547042084P0800X
NJ25MA085953002084P0800X
OH0994002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry