Provider Demographics
NPI:1396742037
Name:CHAUDHRY, ABDUL W (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:W
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4560 SOUTH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1160
Mailing Address - Country:US
Mailing Address - Phone:757-623-0005
Mailing Address - Fax:757-548-1129
Practice Address - Street 1:814 KEMPSVILLE RD
Practice Address - Street 2:SUITE 102 BLDG 17
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4001
Practice Address - Country:US
Practice Address - Phone:757-623-0005
Practice Address - Fax:757-389-5412
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2019-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053259207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA243439OtherBCBS
VA005814031Medicaid
VA541371648OtherTAX ID
VA005814031Medicaid
E21650Medicare UPIN