MEDICARE: MOHAMMAD AZHAR CHAUDHRY M.D., F.C.C.P

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD017440E	PA
2	207R00000X	Internal Medicine Physician	MD017440E	PA
3	207RP1001X	Pulmonary Disease Physician	MD017440E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PPO7356405	OTHER	PA	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	50091558	OTHER	PA	CAPITAL BLUE CROSS
4	816334	OTHER	PA	FIRST PRIORITY
5	000000139970	OTHER	PA	MED PLUS
6	HMO3222446	OTHER	PA	AETNA
7	CHI1457706	OTHER	PA	BC/BS
8	124443	OTHER	PA	HIGHMARK BLUE SHIELD
9	P00023022	OTHER	PA	RR MC
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093792459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMAD AZHAR CHAUDHRY M.D., F.C.C.P

Provider Business Mailing Address
First Line	:	206 E BROWN ST
Second Line	:	POCONO HEALTHCARE MANAGEMENT-PROFESSIONAL CENTER
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18301-3006
Country	:	US
Telephone Number	:	570-426-2733
Fax Number	:	570-426-2643

Provider Business Practice Location Address
First Line	:	600 COMMERCE BLVD
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6214
Country	:	US
Telephone Number	:	570-420-9227
Fax Number	:	570-420-9244

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	08/29/2016

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