Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101233549 | VA |
N | 2080P0210X | Pediatric Nephrologist | 0101233549 | VA |
Y | 2080P0210X | Pediatric Nephrologist | 2010015651 | MO |
NPI | 1124121553 |
---|---|
Provider Name | Dr. Vimal Chadha |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 14/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010006376 | (05) | VA |
H91505 | (02) |