Provider Demographics
NPI:1528163680
Name:NAND, CHETA (MD)
Entity type:Individual
Prefix:
First Name:CHETA
Middle Name:
Last Name:NAND
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 1:15563 PECOTA PL
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-5150
Mailing Address - Country:US
Mailing Address - Phone:509-961-3849
Mailing Address - Fax:
Practice Address - Street 1:1446 SPAULDING AVE STE 301
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4720
Practice Address - Country:US
Practice Address - Phone:509-737-1447
Practice Address - Fax:509-737-1553
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000383362084P0802X, 2084P0800X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA247480OtherLABOR & INDUSTRIES
WA607333500OtherOWCP/FECA
WA8541138Medicaid
WA319100600OtherGROUP PIN
WA8253213Medicaid
WA607333500OtherOWCP/FECA
WA319100600OtherGROUP PIN
WAAB15064Medicare PIN