Provider Demographics
NPI:1467680918
Name:CHAUDHARI, SAMEER SADASHIV (MD)
Entity Type:Individual
Prefix:
First Name:SAMEER
Middle Name:SADASHIV
Last Name:CHAUDHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:980-302-8659
Mailing Address - Fax:980-302-8674
Practice Address - Street 1:15830 BALLANTYNE MEDICAL PL STE 275
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4791
Practice Address - Country:US
Practice Address - Phone:980-302-8659
Practice Address - Fax:980-302-8674
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01100207R00000X, 207RC0000X
MDP23983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine