Provider Demographics
NPI:1922212166
Name:CHADA, MADHAVI (M D)
Entity Type:Individual
Prefix:DR
First Name:MADHAVI
Middle Name:
Last Name:CHADA
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:MADHAVI
Other - Middle Name:
Other - Last Name:YERRAMILLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M D
Mailing Address - Street 1:12150 ANNAPOLIS RD STE 209
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9183
Mailing Address - Country:US
Mailing Address - Phone:240-929-6652
Mailing Address - Fax:240-929-6710
Practice Address - Street 1:12150 ANNAPOLIS RD STE 209
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9183
Practice Address - Country:US
Practice Address - Phone:240-929-6652
Practice Address - Fax:240-929-6710
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08999000207L00000X
NY243748207R00000X
MDD76707207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine