Provider Demographics
NPI:1700265576
Name:CHAUDHARI, SOHAM (DO)
Entity Type:Individual
Prefix:DR
First Name:SOHAM
Middle Name:
Last Name:CHAUDHARI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3722
Mailing Address - Country:US
Mailing Address - Phone:304-529-0900
Mailing Address - Fax:
Practice Address - Street 1:1934 11TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3722
Practice Address - Country:US
Practice Address - Phone:304-529-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO2748207N00000X
TXR0204207N00000X
WV3588207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology