Provider Demographics
NPI:1942734017
Name:CHAWLA, SATISH KUMAR
Entity Type:Individual
Prefix:DR
First Name:SATISH
Middle Name:KUMAR
Last Name:CHAWLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5546 PORTAGE RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L2E 6X2
Mailing Address - Country:CA
Mailing Address - Phone:905-358-0171
Mailing Address - Fax:
Practice Address - Street 1:5546 PORTAGE RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:ONTARIO
Practice Address - Zip Code:L2E 6X2
Practice Address - Country:CA
Practice Address - Phone:905-358-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270122207ZP0101X
MI4301060745207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology