Provider Demographics
NPI:1538422548
Name:CHAUDHRY, KHAWAR ASLAM (MD)
Entity type:Individual
Prefix:
First Name:KHAWAR
Middle Name:ASLAM
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 1:34904 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1766
Mailing Address - Country:US
Mailing Address - Phone:734-713-7189
Mailing Address - Fax:734-263-1295
Practice Address - Street 1:34815 W MICHIGAN AVE STE 1
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1895
Practice Address - Country:US
Practice Address - Phone:734-713-7189
Practice Address - Fax:734-263-1295
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301101413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M32310Medicare PIN