Provider Demographics
NPI:1568654507
Name:M. HAFEEZ CHAUDHRY MD PA
Entity Type:Organization
Organization Name:M. HAFEEZ CHAUDHRY MD PA
Other - Org Name:THE HEART CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-891-1066
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6384
Mailing Address - Country:US
Mailing Address - Phone:301-891-1066
Mailing Address - Fax:
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6384
Practice Address - Country:US
Practice Address - Phone:301-891-1066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014364207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD913751300Medicaid
MDD09340Medicare UPIN
MD913751300Medicaid