Provider Demographics
NPI:1376938993
Name:CHOWDHURY, JEHAN F (DO)
Entity Type:Individual
Prefix:
First Name:JEHAN
Middle Name:F
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:DO
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 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9680
Mailing Address - Fax:239-343-4178
Practice Address - Street 1:2780 CLEVELAND AVE STE 809
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5817
Practice Address - Country:US
Practice Address - Phone:239-343-9680
Practice Address - Fax:239-343-4178
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272516207RI0200X
390200000X
FLOS18888207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1376938993Medicaid
FL115079200Medicaid