Provider Demographics
NPI:1649760992
Name:CHAUDHARY, KANOOZ UL QADIR (MD)
Entity Type:Individual
Prefix:DR
First Name:KANOOZ
Middle Name:UL QADIR
Last Name:CHAUDHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ARROW SPRINGS BLVD STE 2700
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7019
Mailing Address - Country:US
Mailing Address - Phone:513-282-7911
Mailing Address - Fax:513-282-7900
Practice Address - Street 1:100 ARROW SPRINGS BLVD STE 2700
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7019
Practice Address - Country:US
Practice Address - Phone:513-282-7911
Practice Address - Fax:513-282-7900
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-12
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0450792Medicaid