Provider Demographics
NPI:1508826702
Name:SHABBIR AHMED CHAUDHRY INC
Entity Type:Organization
Organization Name:SHABBIR AHMED CHAUDHRY INC
Other - Org Name:SHABBIR CHAUDRY MD INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHABBIR
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-843-2345
Mailing Address - Street 1:5611 MOSTELLER DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4137
Mailing Address - Country:US
Mailing Address - Phone:405-843-2345
Mailing Address - Fax:405-843-8237
Practice Address - Street 1:5611 MOSTELLER DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4137
Practice Address - Country:US
Practice Address - Phone:405-843-2345
Practice Address - Fax:405-843-8237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKE11357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty