Provider Demographics
NPI:1225042401
Name:CHAUDHARY, SAFDAR I (MD)
Entity Type:Individual
Prefix:DR
First Name:SAFDAR
Middle Name:I
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 1:100 EAGLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1800
Mailing Address - Country:US
Mailing Address - Phone:800-255-2019
Mailing Address - Fax:
Practice Address - Street 1:100 EAGLEVILLE RD
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1800
Practice Address - Country:US
Practice Address - Phone:800-255-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000224302084P0800X
AZ442382084P0800X
PAMD039373E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA503013TVFMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER