Basic Information
Provider Information
NPI: 1952593451
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHADHA
FirstName: CHHAVI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8170 33RD AVE S
Address2: MS21110Q
City: MINNEAPOLIS
State: MN
PostalCode: 554254516
CountryCode: US
TelephoneNumber: 9528835375
FaxNumber: 6123711673
Practice Location
Address1: 2220 RIVERSIDE AVE - MAIL STOP 31700A
Address2: HEALTHPARTNERS RIVERSIDE CLINIC
City: MINNEAPOLIS
State: MN
PostalCode: 554541321
CountryCode: US
TelephoneNumber: 6123415000
FaxNumber: 6123711673
Other Information
ProviderEnumerationDate: 08/17/2007
LastUpdateDate: 12/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101XA89113CAY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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