Dossu J Chanduwadia, M.D.

Individual provider Active NPI Obstetrics & Gynecology Physician · Festus, MO

NPI 1790848950 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1790848950
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
MD35388 (MO)
Practice address
1400 US Highway 61
Suite 110
Festus, MO 63028-4100
Phone
(636) 933-6070
Fax
(636) 933-0942
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD35388MOMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD35388 MO Yes

Addresses

Primary practice location

1400 US Highway 61
Suite 110
Festus, MO 63028-4100

Mailing address

1400 US Highway 61
Suite 110
Festus, MO 63028-4100
Phone (636) 933-6070

Other identifiers

IdentifierTypeStateIssuer
07154OtherMOBLUE CROSS BLUE SHIELD
241846OtherMOHEALTHLINK NUMBER
7286OtherMOGHP NUMBER

Other names

  • Dr. DJC Wadia Other name

Other providers in Festus, MO

All providers in Festus, MO · Obstetrics & Gynecology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.