Provider Demographics
NPI:1134155104
Name:CHAUDHRY, MOHAMMAD HAFEEZ (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:HAFEEZ
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HEART
Other - Middle Name:CENTER
Other - Last Name:M.H.CHAUDHRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6384
Mailing Address - Country:US
Mailing Address - Phone:301-891-1066
Mailing Address - Fax:301-270-2843
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6384
Practice Address - Country:US
Practice Address - Phone:301-891-1066
Practice Address - Fax:301-270-2843
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014364174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD913751300Medicaid
MD108102H33Medicare PIN
MDD09340Medicare UPIN