Healthcare Provider Details

I. General information

NPI: 1154491611
Provider Name (Legal Business Name): TIM CHOWDHURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 SAWMILL RD SUITE A
DUBLIN OH
43016-5008
US

IV. Provider business mailing address

7211 SAWMILL RD SUITE 101
DUBLIN OH
43016-5008
US

V. Phone/Fax

Practice location:
  • Phone: 614-326-0511
  • Fax:
Mailing address:
  • Phone: 614-793-8817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35.080788
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35080788
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: