MEDICARE: DEEPAK CHOWDHARY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	22734	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306895636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEEPAK CHOWDHARY MD

Provider Business Mailing Address
First Line	:	PO BOX 3239
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29502-3239
Country	:	US
Telephone Number	:	843-777-7120
Fax Number	:	843-777-7102

Provider Business Practice Location Address
First Line	:	401 E CHEVES ST
Second Line	:	SUITE 301
City	:	FLORENCE
State	:	SC
Zip	:	29506-2615
Country	:	US
Telephone Number	:	843-777-7166
Fax Number	:	843-777-7167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	05/10/2016

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