Provider Demographics
NPI:1932187499
Name:CHAUDHARY, SHAHID M (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:M
Last Name:CHAUDHARY
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 1:99 CALLE PALENCIA, URB. SULTANA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4633
Mailing Address - Country:US
Mailing Address - Phone:787-673-1238
Mailing Address - Fax:
Practice Address - Street 1:ROCHELAISE CENTER, WESTERN INDUST PARK. OFICINA 3B
Practice Address - Street 2:CARR 114, KM 0.4
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-0068
Practice Address - Country:US
Practice Address - Phone:787-412-7805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19793208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice