Provider Demographics
NPI:1063446185
Name:CHOWDHURY, SHAHIDA B (MD)
Entity Type:Individual
Prefix:
First Name:SHAHIDA
Middle Name:B
Last Name:CHOWDHURY
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 1:55 WADE AVEUNE
Mailing Address - Street 2:SPRING GROVE HOSPITAL
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-402-7630
Mailing Address - Fax:410-402-7710
Practice Address - Street 1:55 WADE AVEUNE
Practice Address - Street 2:SPRING GROVE HOSPITAL
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-402-7630
Practice Address - Fax:410-402-7710
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00592392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H70950Medicare UPIN