Healthcare Provider Details

I. General information

NPI: 1841288685
Provider Name (Legal Business Name): UMBREEN J CHAUDHARY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N FAYETTEVILLE ST STE 301
ASHEBORO NC
27203-4671
US

IV. Provider business mailing address

610 N FAYETTEVILLE ST SUITE 300
ASHEBORO NC
27203-4670
US

V. Phone/Fax

Practice location:
  • Phone: 336-633-4034
  • Fax: 866-467-6816
Mailing address:
  • Phone: 336-633-4020
  • Fax: 336-633-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number200400470
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200400470
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: