Provider Demographics
NPI:1255544748
Name:CHAUDHARY, NAHLA
Entity type:Individual
Prefix:DR
First Name:NAHLA
Middle Name:
Last Name:CHAUDHARY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:NAHLA
Other - Middle Name:
Other - Last Name:CHOUDHARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1007 SUSHRUTA DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8876
Mailing Address - Country:US
Mailing Address - Phone:304-263-0991
Mailing Address - Fax:304-274-9546
Practice Address - Street 1:1007 SUSHRUTA DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8876
Practice Address - Country:US
Practice Address - Phone:304-263-0991
Practice Address - Fax:304-274-9546
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50 0543221223S0112X
WV38811223S0112X
MD145531223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810015183Medicaid
WV3810015183Medicaid