Provider Demographics
NPI:1073786794
Name:CHAUDHARY, ASAD JUNAID (MD)
Entity Type:Individual
Prefix:
First Name:ASAD
Middle Name:JUNAID
Last Name:CHAUDHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 E CAMELBACK RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2322
Mailing Address - Country:US
Mailing Address - Phone:602-997-0484
Mailing Address - Fax:602-944-6882
Practice Address - Street 1:1520 S DOBSON RD STE 304
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4727
Practice Address - Country:US
Practice Address - Phone:480-899-0767
Practice Address - Fax:480-899-1145
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43031207R00000X
AZ47859207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ821019Medicaid
AZ86-0959487OtherTIN
AZ86-0959487OtherTIN