Provider Demographics
NPI:1932195823
Name:CHAUDHRY, TANVEER AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:TANVEER
Middle Name:AHMAD
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 1:4800 ROWAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-5609
Mailing Address - Country:US
Mailing Address - Phone:352-678-5550
Mailing Address - Fax:352-678-5551
Practice Address - Street 1:17222 HOSPITAL BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-8906
Practice Address - Country:US
Practice Address - Phone:352-678-5550
Practice Address - Fax:352-678-5551
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85148207R00000X, 208D00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00807407OtherMEDICARE RAILROAD
FL62852TOtherMEDICARE
FL116647700Medicaid
FL62852OtherBCBS
FLP00807407OtherMEDICARE RAILROAD
FL62852OtherBCBS
FL62852ZMedicare ID - Type Unspecified