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General NPI Number Information
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NPI Number | 1790883627
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Entity Type | Individual
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Provider Name | VIMAL B CHOUDHARI MD
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 800 W MEETING ST
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City | LANCASTER
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State | SC
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Zip | 29720-2202
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Country | US
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Telephone | 843-792-1414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 935722
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City | ATLANTA
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State | GA
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Zip | 31193-5722
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Country | US
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Telephone | 843-792-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 21895
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101242390
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2016-02291
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MMD.39240
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License Number State | SC
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