Provider Demographics
NPI:1477057461
Name:CHOUDHARY, FAHAD KARIM (MD)
Entity Type:Individual
Prefix:DR
First Name:FAHAD
Middle Name:KARIM
Last Name:CHOUDHARY
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 1:2491 ARBOR WALK CT NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-3044
Mailing Address - Country:US
Mailing Address - Phone:404-405-3538
Mailing Address - Fax:
Practice Address - Street 1:100 FRIST CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3578
Practice Address - Country:US
Practice Address - Phone:706-494-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89384207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine