Provider Demographics
NPI:1790171783
Name:CHOWDHURY, TEMUR
Entity Type:Individual
Prefix:
First Name:TEMUR
Middle Name:
Last Name:CHOWDHURY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 E 28TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1453
Mailing Address - Country:US
Mailing Address - Phone:612-333-0770
Mailing Address - Fax:
Practice Address - Street 1:2020 E 28TH ST STE 104
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1453
Practice Address - Country:US
Practice Address - Phone:612-333-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN64381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine