MEDICARE: DR. MUNDEEP CHAUDHRY 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	207Q00000X	Family Medicine Physician	35.122598	OH
2	2083X0100X	Occupational Medicine Physician	35.122598	OH

General Provider Information

NPI Number	:	1396870259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUNDEEP CHAUDHRY MD

Provider Business Mailing Address
First Line	:	39000 CENTER RIDGE RD
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-2742
Country	:	US
Telephone Number	:	440-329-7490
Fax Number	:

Provider Business Practice Location Address
First Line	:	39000 CENTER RIDGE RD
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-2742
Country	:	US
Telephone Number	:	440-329-7490
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	11/04/2016

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