Provider Demographics
NPI:1477833028
Name:CHOUDHRY, BASSAM TAHIR (MD, MPH)
Entity type:Individual
Prefix:
First Name:BASSAM
Middle Name:TAHIR
Last Name:CHOUDHRY
Suffix:
Gender:
Credentials:MD, MPH
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 11407
Mailing Address - Street 2:DEPT# 5839
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5839
Mailing Address - Country:US
Mailing Address - Phone:256-320-5019
Mailing Address - Fax:256-978-5769
Practice Address - Street 1:6200 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3529
Practice Address - Country:US
Practice Address - Phone:520-742-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ65859207R00000X
ALMD.38735207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine