Provider Demographics
NPI:1639673031
Name:CHOUDHARY, REWA K (MD, MPH)
Entity Type:Individual
Prefix:
First Name:REWA
Middle Name:K
Last Name:CHOUDHARY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 UPPERGATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-727-1471
Mailing Address - Fax:404-727-3236
Practice Address - Street 1:2015 UPPERGATE DRIVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-727-1471
Practice Address - Fax:404-727-3236
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60865406208000000X
GA87977208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics