Provider Demographics
NPI:1821252750
Name:CHAUDHRY, QASIM LATIF (MB BCH)
Entity Type:Individual
Prefix:DR
First Name:QASIM
Middle Name:LATIF
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MB BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:1212 PLEASANT ST
Practice Address - Street 2:STE. 211
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309
Practice Address - Country:US
Practice Address - Phone:515-875-9770
Practice Address - Fax:515-875-9771
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-39019208600000X, 204F00000X
IA39019204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1622081Medicare PIN
IAIB1621081Medicare PIN
IA513910021Medicare PIN