Provider Demographics
NPI:1932529732
Name:CHAUDHURI, MUNIR (MD)
Entity Type:Individual
Prefix:
First Name:MUNIR
Middle Name:
Last Name:CHAUDHURI
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 1:1364 CLIFTON ROAD NE BOX M7
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-778-4181
Mailing Address - Fax:323-266-2657
Practice Address - Street 1:1364 CLIFTON ROAD NE BOX M7
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1029
Practice Address - Country:US
Practice Address - Phone:404-778-4181
Practice Address - Fax:323-266-2657
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA078764208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMC3232667556Medicaid