{
"Npi": {
"NPI": "1538361506",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHAUDRY",
"FirstName": "MOHAMMED",
"MiddleName": "M.",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 756",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ABINGDON",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21009-0756",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "443-267-4955",
"MailingAddressFaxNumber": "410-847-2316",
"FirstLinePracticeLocationAddress": "34 N PHILADELPHIA BLVD STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ABERDEEN",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21001-2511",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-267-4955",
"PracticeLocationAddressFaxNumber": "410-847-2316",
"EnumerationDate": "06/01/2007",
"LastUpdateDate": "02/01/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "A1-0003326",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "RP438344",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "16832",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "C7-0003801",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2086S0129X",
"TaxonomyName": "Vascular Surgery Physician",
"LicenseNumber": "C1-0011411",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2086S0129X",
"TaxonomyName": "Vascular Surgery Physician",
"LicenseNumber": "37936",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2086S0129X",
"TaxonomyName": "Vascular Surgery Physician",
"LicenseNumber": "D77458",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}