Provider Demographics
NPI:1245218460
Name:CHOUDHURY, SHAHANA ASHRAF (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHANA
Middle Name:ASHRAF
Last Name:CHOUDHURY
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 1:310 25TH AVENUE NORTH
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-620-5154
Mailing Address - Fax:615-321-5205
Practice Address - Street 1:800 WEATHERLY DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8943
Practice Address - Country:US
Practice Address - Phone:931-648-1912
Practice Address - Fax:931-648-1277
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN312672080P0208X
TN71727208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441915Medicaid
TN3897878Medicaid
TN33256121Medicare PIN
TNG78137Medicare UPIN