Healthcare Provider Details

I. General information

NPI: 1629110986
Provider Name (Legal Business Name): BILAL AHMAD CHAUDHRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S FLOYD ST SUITE 407
LOUISVILLE KY
40202-1835
US

IV. Provider business mailing address

3001 BROOKHAVEN RD
NEW ALBANY IN
47150-9439
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-2880
  • Fax:
Mailing address:
  • Phone: 502-648-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01070386A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number44798
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: