Healthcare Provider Details

I. General information

NPI: 1407276827
Provider Name (Legal Business Name): ISHA CHOUDHARY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 PLUM ORCHARD DR
SILVER SPRING MD
20904-7803
US

IV. Provider business mailing address

2101 E JEFFERSON ST STE 6W
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 301-699-7700
  • Fax:
Mailing address:
  • Phone: 301-816-5953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD83972
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: