Provider Demographics
NPI:1962085415
Name:CHOWDHURY, SHRIA ROY
Entity type:Individual
Prefix:
First Name:SHRIA
Middle Name:ROY
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31366 PICKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-4608
Mailing Address - Country:US
Mailing Address - Phone:248-477-6778
Mailing Address - Fax:
Practice Address - Street 1:31366 PICKFORD AVE
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-4608
Practice Address - Country:US
Practice Address - Phone:248-477-6778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant