Healthcare Provider Details

I. General information

NPI: 1205279122
Provider Name (Legal Business Name): MUBASHAR A CHOUDRY MD OF NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 PARKSIDE AVE SUITE D18
EWING NJ
08638-2946
US

IV. Provider business mailing address

15245 SHADY GROVE RD SUITE 325
ROCKVILLE MD
20850-3222
US

V. Phone/Fax

Practice location:
  • Phone: 301-891-2500
  • Fax:
Mailing address:
  • Phone: 301-434-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: M.ASHRAF MEELU
Title or Position: DIRECTOR
Credential: MD
Phone: 301-434-0050