Healthcare Provider Details

I. General information

NPI: 1033659180
Provider Name (Legal Business Name): ARKA CHAUDHURY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 05/08/2024
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 BEAMAN ST
CLINTON NC
28328-2603
US

IV. Provider business mailing address

2503 E LYON STATION RD
CREEDMOOR NC
27522-9112
US

V. Phone/Fax

Practice location:
  • Phone: 910-596-5421
  • Fax:
Mailing address:
  • Phone: 919-528-1535
  • Fax: 919-528-8307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2020-04856
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: