Provider Demographics
NPI:1548572290
Name:CHOUDHARY, GOHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:GOHAR
Middle Name:
Last Name:CHOUDHARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43130 AMBERWOOD PLZ
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-4105
Mailing Address - Country:US
Mailing Address - Phone:703-348-0030
Mailing Address - Fax:703-542-7770
Practice Address - Street 1:43130 AMBERWOOD PLZ
Practice Address - Street 2:SUITE 140
Practice Address - City:SOUTH RIDING
Practice Address - State:VA
Practice Address - Zip Code:20152-4105
Practice Address - Country:US
Practice Address - Phone:703-348-0030
Practice Address - Fax:703-542-7770
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012520602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry