Provider Demographics
NPI:1184603383
Name:CHAUHAN, AMBARAM V (MD)
Entity type:Individual
Prefix:DR
First Name:AMBARAM
Middle Name:V
Last Name:CHAUHAN
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 1:1645 ROSTRAVER RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-9655
Mailing Address - Country:US
Mailing Address - Phone:724-929-2640
Mailing Address - Fax:724-929-4308
Practice Address - Street 1:1200 BROOKS LN STE 110
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3749
Practice Address - Country:US
Practice Address - Phone:412-466-5502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD37996L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008635790004Medicaid
PA0008635790004Medicaid
181174K55Medicare ID - Type Unspecified