Healthcare Provider Details

I. General information

NPI: 1134642960
Provider Name (Legal Business Name): MOHAMMAD RAUF CHAUDHRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRESHAM DR STE 8610
NORFOLK VA
23507-1904
US

IV. Provider business mailing address

600 GRESHAM DR STE 8610
NORFOLK VA
23507-1904
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-9015
  • Fax: 757-510-9041
Mailing address:
  • Phone: 757-252-9015
  • Fax: 757-510-9041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD2021-1184
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberC1-0028832
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101278244
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10061789
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: