Provider Demographics
NPI:1487613865
Name:CHAUDHRY INC, SHABBIR AHMED (MD)
Entity type:Individual
Prefix:DR
First Name:SHABBIR
Middle Name:AHMED
Last Name:CHAUDHRY INC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SHABBIR
Other - Middle Name:AHMED
Other - Last Name:CHAUDRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5611 MOSTELLER DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4137
Mailing Address - Country:US
Mailing Address - Phone:405-843-2345
Mailing Address - Fax:405-843-8237
Practice Address - Street 1:5611 MOSTELLER DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4137
Practice Address - Country:US
Practice Address - Phone:405-843-2345
Practice Address - Fax:405-843-8237
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100041730AMedicaid
OKE11357Medicare UPIN
OK100041730AMedicaid
233610101Medicare PIN