Provider Demographics
NPI:1457502940
Name:KHALID CHOWDHURY MD, PC
Entity Type:Organization
Organization Name:KHALID CHOWDHURY MD, PC
Other - Org Name:KHALID CHOWDHURY MD, PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, FRCSC, FACS
Authorized Official - Phone:303-839-5155
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:303-839-5155
Mailing Address - Fax:303-839-5255
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:SUITE 3000
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-839-5155
Practice Address - Fax:303-839-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35707207YS0123X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO87351781Medicaid
CO87351781Medicaid