Provider Demographics
NPI:1316951379
Name:CHAUDHURI, SUDHA T (MD)
Entity type:Individual
Prefix:
First Name:SUDHA
Middle Name:T
Last Name:CHAUDHURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUDHA
Other - Middle Name:KUSHALCHAND
Other - Last Name:HIRANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6225 RAYTOWN TRFY
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-3846
Mailing Address - Country:US
Mailing Address - Phone:816-353-2400
Mailing Address - Fax:
Practice Address - Street 1:825 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64124-2323
Practice Address - Country:US
Practice Address - Phone:816-474-4920
Practice Address - Fax:816-474-4914
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO34834207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200693026Medicaid
C162808OtherMEDICARE B
C162808OtherMEDICARE B
C52161Medicare UPIN