Provider Demographics
NPI:1952399784
Name:CHODRI, TANVIR ANWAR (MD)
Entity Type:Individual
Prefix:MR
First Name:TANVIR
Middle Name:ANWAR
Last Name:CHODRI
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 1:610 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
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4670
Practice Address - Country:US
Practice Address - Phone:336-633-4020
Practice Address - Fax:336-633-4069
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300323174400000X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913493Medicaid
C6314OtherMEDCOST
P00112488OtherRAILROAD MEDICARE
13493OtherBCBS
2295441OtherCIGNA
480035OtherUNITED HEALTHCARE
P00112488OtherRAILROAD MEDICARE
NC2021003AMedicare ID - Type Unspecified
NC8913493Medicaid