Provider Demographics
NPI:1992037121
Name:CHOUDHARY, MOHAMMAD SALMAN (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:SALMAN
Last Name:CHOUDHARY
Suffix:
Gender:M
Credentials:MD PHD
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 770536
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32877-0536
Mailing Address - Country:US
Mailing Address - Phone:786-495-4591
Mailing Address - Fax:
Practice Address - Street 1:5243 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1814
Practice Address - Country:US
Practice Address - Phone:786-495-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17816208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice