MEDICARE: DR. JASBIR CHOWDHARY MD

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	207Q00000X	Family Medicine Physician	D23522	MD
2	207Q00000X	Family Medicine Physician	MD9528	DC
3	207Q00000X	Family Medicine Physician	0101033499	VA

General Provider Information

NPI Number	:	1508921834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASBIR CHOWDHARY MD

Provider Business Mailing Address
First Line	:	2101 EAST JEFFERSON STREET
Second Line	:	PPQA MEDICARE COMPLIANCE UNIT 6 WEST
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4908
Country	:	US
Telephone Number	:	301-816-6660
Fax Number	:	301-816-6308

Provider Business Practice Location Address
First Line	:	11921 BOURNEFIELD WAY STE B
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7815
Country	:	US
Telephone Number	:	301-879-6140
Fax Number	:	301-879-6192

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	11/14/2011

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