Healthcare Provider Details

I. General information

NPI: 1710426408
Provider Name (Legal Business Name): IMRAN AHMAD CHUGHTAI PHARMD., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2017
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13975 CONNECTICUT AVE SUITE 250
SILVER SPRING MD
20906-2921
US

IV. Provider business mailing address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1460
US

V. Phone/Fax

Practice location:
  • Phone: 301-557-1950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number22464
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number22464
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number22464
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: