Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 25784 | NC |
NPI | 1124070586 |
---|---|
Provider Name | Abdul Chaudhry |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 17/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0135L | BCBS NC (01) | NC |
890135L | (05) | NC |
8922106 | (05) | NC |
E14227 | (02) | |
E14227 | (02) | NC |