Provider Demographics
NPI:1932187499
Name:CHAUDHARY, SHAHID M (MD)
Entity Type:Individual
Prefix:
First Name:SHAHID
Middle Name:M
Last Name:CHAUDHARY
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 1:184 CALLE VALENCIA
Mailing Address - Street 2:URB. LA SALAMANCA
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4633
Mailing Address - Country:US
Mailing Address - Phone:787-673-1238
Mailing Address - Fax:
Practice Address - Street 1:CALLE VALENCIA 184
Practice Address - Street 2:LA SALAMANCA
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4633
Practice Address - Country:US
Practice Address - Phone:787-892-1648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19793208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice