Provider Demographics
NPI:1174540033
Name:AHLUWALIA, CHARANJIT S (MD)
Entity type:Individual
Prefix:MR
First Name:CHARANJIT
Middle Name:S
Last Name:AHLUWALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1855 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4093
Mailing Address - Country:US
Mailing Address - Phone:407-645-2334
Mailing Address - Fax:407-647-5691
Practice Address - Street 1:1855 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4093
Practice Address - Country:US
Practice Address - Phone:407-645-2334
Practice Address - Fax:407-647-5691
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 116573207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA82355Medicare UPIN
OHAH0578538Medicare PIN