MEDICARE: NORTH DAVIS NEUROLOGY INC

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	2084N0400X	Neurology Physician	97335689-1205	UT

General Provider Information

NPI Number	:	1326374000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH DAVIS NEUROLOGY INC

Provider Business Mailing Address
First Line	:	PO BOX 1246
Second Line	:
City	:	BOUNTIFUL
State	:	UT
Zip	:	84011-1246
Country	:	US
Telephone Number	:	801-294-6907
Fax Number	:	801-294-6917

Provider Business Practice Location Address
First Line	:	1660 W ANTELOPE DR
Second Line	:	SUITE 320
City	:	LAYTON
State	:	UT
Zip	:	84041-1156
Country	:	US
Telephone Number	:	801-825-8900
Fax Number	:	801-825-2186

Authorized Official
Title or Position	:	NEUROLOGIST
Name	:	DR. ARIF A CHOWDHURY
Credential	:	MD
Telephone Number	:	801-825-8900

Provider Enumeration Date	:	10/30/2009
Last Update Date	:	05/31/2012

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