Provider Demographics
NPI:1982862736
Name:CHAUDARY, KAMRAN MOHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:KAMRAN
Middle Name:MOHAMMAD
Last Name:CHAUDARY
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 1:4918 EAST WESTRIDGE
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-6762
Mailing Address - Country:US
Mailing Address - Phone:337-513-7283
Mailing Address - Fax:337-478-3218
Practice Address - Street 1:4918 E WESTRIDGE PARK DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-6762
Practice Address - Country:US
Practice Address - Phone:337-513-7283
Practice Address - Fax:337-478-3182
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine