Provider Demographics
NPI:1841288685
Name:CHAUDHARY, UMBREEN J (MD)
Entity type:Individual
Prefix:MRS
First Name:UMBREEN
Middle Name:J
Last Name:CHAUDHARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N FAYETTEVILLE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4670
Mailing Address - Country:US
Mailing Address - Phone:336-633-4020
Mailing Address - Fax:336-633-4069
Practice Address - Street 1:610 N FAYETTEVILLE ST STE 301
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4671
Practice Address - Country:US
Practice Address - Phone:336-633-4034
Practice Address - Fax:866-467-6816
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400470174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89138GEMedicaid
2188524OtherCIGNA
D6686OtherMEDCOST
138GEOtherBCBS
2417273OtherUNITED HEALTHCARE
2188524OtherCIGNA
NCI19545Medicare UPIN