Provider Demographics
NPI:1457452260
Name:CHAUHAN, AJIT S (MD)
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:S
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 1:1045 MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1800
Mailing Address - Country:US
Mailing Address - Phone:434-792-4400
Mailing Address - Fax:434-792-4500
Practice Address - Street 1:1045 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1800
Practice Address - Country:US
Practice Address - Phone:434-792-4400
Practice Address - Fax:434-792-4500
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010395008207R00000X
VA0101039508207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005833086Medicaid
NC890630KMedicaid
VA49D0959020OtherCLIA
VA005833086Medicaid
NC890630KMedicaid