Healthcare Provider Details

I. General information

NPI: 1891322152
Provider Name (Legal Business Name): TAHSIN CHOUDHURY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 59TH ST W
BRADENTON FL
34209-4604
US

IV. Provider business mailing address

4141 SHORE DR
INDIANAPOLIS IN
46254-2607
US

V. Phone/Fax

Practice location:
  • Phone: 941-798-6513
  • Fax:
Mailing address:
  • Phone: 317-329-2525
  • Fax: 317-329-2360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number02008305A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number02008305A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: