Healthcare Provider Details

I. General information

NPI: 1568030310
Provider Name (Legal Business Name): AMAAD CHAUDHRY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date: 04/06/2023
Reactivation Date: 06/19/2023

III. Provider practice location address

1821 S STOUGHTON RD
MADISON WI
53716-2257
US

IV. Provider business mailing address

1821 S STOUGHTON RD
MADISON WI
53716-2257
US

V. Phone/Fax

Practice location:
  • Phone: 608-260-6000
  • Fax: 608-260-6451
Mailing address:
  • Phone: 608-260-6000
  • Fax: 608-260-6451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number83850-20
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number83850-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: