Provider Demographics
NPI:1770879868
Name:CHOUDHRY CHANDAN, OJASVINI (MD)
Entity type:Individual
Prefix:
First Name:OJASVINI
Middle Name:
Last Name:CHOUDHRY CHANDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20158 D ST
Mailing Address - Street 2:APT 117
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-5076
Mailing Address - Country:US
Mailing Address - Phone:402-305-5484
Mailing Address - Fax:
Practice Address - Street 1:1349 S 101ST ST
Practice Address - Street 2:APT 117
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1094
Practice Address - Country:US
Practice Address - Phone:402-305-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6581208000000X
NE280632080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics