Provider Demographics
| NPI: | 1811965668 |
|---|---|
| Name: | CHAUDHRY, ARSHAD NAZIR (MD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | ARSHAD |
| Middle Name: | NAZIR |
| 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: | 125 EXECUTIVE DR |
| Mailing Address - Street 2: | SUITE 201 |
| Mailing Address - City: | MARION |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 43302-6285 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 740-387-4090 |
| Mailing Address - Fax: | 740-387-5906 |
| Practice Address - Street 1: | 125 EXECUTIVE DR |
| Practice Address - Street 2: | SUITE 201 |
| Practice Address - City: | MARION |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 43302-6285 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 740-387-4090 |
| Practice Address - Fax: | 740-387-5906 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2006-03-09 |
| Last Update Date: | 2008-04-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| OH | 35-047804 | 207R00000X, 207RH0003X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| OH | 0494906 | Medicaid | |
| 0516056 | Medicare PIN | ||
| A15173 | Medicare UPIN |