Provider Demographics
NPI:1699728089
Name:IMRAN H CHOWDHURY MD PA
Entity type:Organization
Organization Name:IMRAN H CHOWDHURY MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-997-7677
Mailing Address - Street 1:9784 OLD ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6327
Mailing Address - Country:US
Mailing Address - Phone:410-997-1336
Mailing Address - Fax:
Practice Address - Street 1:10816 HICKORY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3622
Practice Address - Country:US
Practice Address - Phone:410-997-7677
Practice Address - Fax:410-997-1636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDN151OtherBLUE CROSS FEDERAL
MD1142274OtherAETNA HMO
GA164694407AMedicaid
DC36579100Medicaid
MD606751OtherEVERCARE
MD7416227OtherAETNA NON HMO
MD409510300Medicaid
MD494COtherBLUE CROSS OF MD
MD494COtherBLUE CROSS OF MD
MD7416227OtherAETNA NON HMO
GA164694407AMedicaid
MD409510300Medicaid
MD157PMedicare PIN
DCG02174Medicare PIN
MDE73945Medicare UPIN
DC36579100Medicaid
MDDE3488Medicare PIN