Provider Demographics
NPI:1356310395
Name:CHAUDHRY, YUSUF M (MD)
Entity Type:Individual
Prefix:DR
First Name:YUSUF
Middle Name:M
Last Name:CHAUDHRY
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 1:420 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1800
Mailing Address - Country:US
Mailing Address - Phone:636-937-0025
Mailing Address - Fax:636-937-9693
Practice Address - Street 1:420 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1800
Practice Address - Country:US
Practice Address - Phone:636-937-0025
Practice Address - Fax:636-937-9693
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4H83207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA26587Medicare UPIN