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General NPI Number Information
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NPI Number | 1790917003
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Entity Type | Organization
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Legal Business Name | IQBAL A. CHOUDHRY, MD, INC.
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 4848 HIGBEE AVE NW
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City | CANTON
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State | OH
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Zip | 44718-2528
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Country | US
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Telephone | 330-492-7827
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Fax | 330-492-7577
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Provider Business Mailing Address
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Address Line | 4848 HIGBEE AVE NW
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City | CANTON
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State | OH
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Zip | 44718-2528
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Country | US
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Telephone | 330-492-7827
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Fax | 330-492-7577
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Authorized Official
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Title or Position | PRESIDENT
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Name | IQBAL A CHOUDHRY
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Credential | MD
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Telephone | 330-492-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 35037288
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License Number State | OH
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