Healthcare Provider Details

I. General information

NPI: 1164583001
Provider Name (Legal Business Name): YASHWANT M CHOWDHARY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E COMMERCE ST
HERNANDO MS
38632-2433
US

IV. Provider business mailing address

692 FAIRWAY TRL
HERNANDO MS
38632-7277
US

V. Phone/Fax

Practice location:
  • Phone: 662-429-9111
  • Fax: 662-429-6111
Mailing address:
  • Phone: 414-517-1058
  • Fax: 901-881-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number18761
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: