Provider Demographics
NPI:1508255480
Name:CHOWDHURY, LATIF
Entity Type:Individual
Prefix:
First Name:LATIF
Middle Name:
Last Name:CHOWDHURY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330A RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2331
Mailing Address - Country:US
Mailing Address - Phone:703-310-4188
Mailing Address - Fax:703-310-4853
Practice Address - Street 1:8330A RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2331
Practice Address - Country:US
Practice Address - Phone:703-310-4188
Practice Address - Fax:703-310-4853
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038598207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine