Provider Demographics
NPI:1912922881
Name:CHAUHAN, SUNIL M (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:M
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:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-223-2832
Mailing Address - Fax:772-223-5653
Practice Address - Street 1:200 SE HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2346
Practice Address - Country:US
Practice Address - Phone:772-223-2388
Practice Address - Fax:772-223-2396
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05006392084N0400X
IL036-1163732084N0400X
FLME1308142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021363000Medicaid
NC5900330Medicaid
FLYEM8UOtherFLORIDA BLUE
ILK30385Medicare ID - Type UnspecifiedINDIVIDUAL #
IL809840Medicare ID - Type UnspecifiedGROUP #
FLYEM8UOtherFLORIDA BLUE
IL036116373Medicaid
ILP00340012 -CA4079Medicare ID - Type UnspecifiedRR