Provider Demographics
NPI:1134662877
Name:CHOWDHURY MEDICAL ASSOCIATES, LLC.
Entity type:Organization
Organization Name:CHOWDHURY MEDICAL ASSOCIATES, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NURUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-530-2737
Mailing Address - Street 1:10012 EDWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2114
Mailing Address - Country:US
Mailing Address - Phone:301-530-2737
Mailing Address - Fax:301-530-1585
Practice Address - Street 1:3000 MCCOMAS AVE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2316
Practice Address - Country:US
Practice Address - Phone:301-933-0060
Practice Address - Fax:301-946-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD907776600Medicaid
MD401333600Medicaid