Provider Demographics
NPI:1700013240
Name:CHAUDHARI, JEFFREY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:CHAUDHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:A
Other - Last Name:CHAUDHARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:135 COMMONWEALTH DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4831
Mailing Address - Country:US
Mailing Address - Phone:864-675-4815
Mailing Address - Fax:864-675-4780
Practice Address - Street 1:135 COMMONWEALTH DR
Practice Address - Street 2:SUITE 210
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4831
Practice Address - Country:US
Practice Address - Phone:864-675-4815
Practice Address - Fax:864-675-4780
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery