Provider Demographics
NPI:1336123553
Name:CHOWDHARI, SHAUKAT HUSSAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAUKAT
Middle Name:HUSSAIN
Last Name:CHOWDHARI
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:PO BOX 46518
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-0105
Mailing Address - Country:US
Mailing Address - Phone:813-977-2222
Mailing Address - Fax:813-977-4222
Practice Address - Street 1:11707 CLUB DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5521
Practice Address - Country:US
Practice Address - Phone:813-977-2222
Practice Address - Fax:813-977-4222
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67887208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050069548OtherRAILROAD MEDICARE
162482000OtherWORKERS COMPENSATION
FL28369OtherBCBS
FL379155600Medicaid
FL28369WMedicare ID - Type Unspecified
FLG21388Medicare UPIN