Healthcare Provider Details

I. General information

NPI: 1336115039
Provider Name (Legal Business Name): SHAZIA R CHAUDHRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 SPRINGFIELD PIKE
CINCINNATI OH
45215-1437
US

IV. Provider business mailing address

1507 SPRINGFIELD PIKE
CINCINNATI OH
45215-1437
US

V. Phone/Fax

Practice location:
  • Phone: 513-821-6500
  • Fax: 513-821-4333
Mailing address:
  • Phone: 513-821-6500
  • Fax: 513-821-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036-114165
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35 085685
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036114165
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2006015214
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: