Provider Demographics
NPI:1669436093
Name:CHAUDHRY, MEHBOOB KHURRAM (MD)
Entity type:Individual
Prefix:
First Name:MEHBOOB
Middle Name:KHURRAM
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 5TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2403
Mailing Address - Country:US
Mailing Address - Phone:412-672-9240
Mailing Address - Fax:412-672-5392
Practice Address - Street 1:1321 5TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2403
Practice Address - Country:US
Practice Address - Phone:412-672-9240
Practice Address - Fax:412-672-5392
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039679-L207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH65161Medicare ID - Type Unspecified
PAA61760Medicare UPIN