Healthcare Provider Details

I. General information

NPI: 1609168749
Provider Name (Legal Business Name): FARHANA CHAUDHARY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2011
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 MEDICAL PLAZA DR
NORTH CHARLESTON SC
29406-9334
US

IV. Provider business mailing address

9300 MEDICAL PLAZA DR
NORTH CHARLESTON SC
29406-9334
US

V. Phone/Fax

Practice location:
  • Phone: 843-847-3225
  • Fax:
Mailing address:
  • Phone: 843-847-3225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number63066
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number172273
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55219
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37412
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number55219
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: