Healthcare Provider Details

I. General information

NPI: 1699728089
Provider Name (Legal Business Name): IMRAN H CHOWDHURY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10816 HICKORY RIDGE RD
COLUMBIA MD
21044-3622
US

IV. Provider business mailing address

9784 OLD ANNAPOLIS RD
ELLICOTT CITY MD
21042-6327
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-7677
  • Fax: 410-997-1636
Mailing address:
  • Phone: 410-997-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IMRAN H CHOWDHURY
Title or Position: PARTNER
Credential: M.D.
Phone: 410-997-7677