Provider Demographics
NPI:1902986987
Name:CHAUDHARY, SHAHID SATTAR (MD)
Entity Type:Individual
Prefix:
First Name:SHAHID
Middle Name:SATTAR
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:PO BOX 1460
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-1460
Mailing Address - Country:US
Mailing Address - Phone:605-622-2895
Mailing Address - Fax:605-622-2896
Practice Address - Street 1:2835 FORT MISSOULA RD STE 203
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7424
Practice Address - Country:US
Practice Address - Phone:406-327-4283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5304207RN0300X
MT58087207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD57401G001OtherTRICARE
ND13467Medicaid
SD4726OtherAVERA HEALTH PLAN
SD6631000Medicaid
SD2188442OtherAMERICA'S PPO
SD5304OtherDAKOTACARE
255950OtherMIDLANDS CHOICE
SD4995138OtherWELLMARK BCBS OF SD
SDS101808Medicare PIN
255950OtherMIDLANDS CHOICE
SDP00178981Medicare PIN