Healthcare Provider Details

I. General information

NPI: 1457502940
Provider Name (Legal Business Name): KHALID CHOWDHURY MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 05/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE SUITE 3000
DENVER CO
80218-1216
US

IV. Provider business mailing address

1601 E 19TH AVE SUITE 3000
DENVER CO
80218-1216
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-5155
  • Fax: 303-839-5255
Mailing address:
  • Phone: 303-839-5155
  • Fax: 303-839-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number35707
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number35707
License Number StateCO

VIII. Authorized Official

Name: KHALID CHOWDHURY
Title or Position: OWNER
Credential: MD, MBA, FRCSC, FACS
Phone: 303-839-5155