Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 4301078654 | MI |
NPI | 1063438018 |
---|---|
Provider Name | Dr. Shoaib Ahmed Chowdhury |
First Address | Cadillac, MI 49601-9720 |
Second Address | Cadillac, MI 49601-9720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 21/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110245345 | RAILROAD MEDICARE (01) | MI |
1108300652 | BLUE CROSS (01) | MI |
433661610 | (05) | MI |