Healthcare Provider Details

I. General information

NPI: 1508065186
Provider Name (Legal Business Name): SHAHRYAR MAJEED CHOWDHURY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE MSC 915
CHARLESTON SC
29425-8909
US

IV. Provider business mailing address

PO BOX 751461
CHARLOTTE NC
28275-1461
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-3300
  • Fax: 843-792-3284
Mailing address:
  • Phone: 843-792-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL29962
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number29962
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: