Provider Demographics
NPI:1710941281
Name:CHOUDRY, MAKSED S (MD)
Entity Type:Individual
Prefix:DR
First Name:MAKSED
Middle Name:S
Last Name:CHOUDRY
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 1:23219 STRINGTOWN ROAD
Mailing Address - Street 2:#334
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871
Mailing Address - Country:US
Mailing Address - Phone:240-433-3355
Mailing Address - Fax:
Practice Address - Street 1:18701 ROXBURY RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21746
Practice Address - Country:US
Practice Address - Phone:240-433-3355
Practice Address - Fax:304-262-1407
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053449207R00000X
VA0101057218207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty