Provider Demographics
NPI:1073772604
Name:CHAUDHRY, FRASAT (MD)
Entity Type:Individual
Prefix:DR
First Name:FRASAT
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:232 S WOODS MILL RD
Mailing Address - Street 2:400 EAST
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3417
Mailing Address - Country:US
Mailing Address - Phone:314-878-2888
Mailing Address - Fax:314-576-8167
Practice Address - Street 1:232 S WOODS MILL RD
Practice Address - Street 2:400 EAST
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3417
Practice Address - Country:US
Practice Address - Phone:314-878-2888
Practice Address - Fax:314-576-8167
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0361186362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO146490003Medicare PIN