MEDICARE: SHABBIR AHMED CHAUDHRY INC

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	207R00000X	Internal Medicine Physician	E11357	OK

General Provider Information

NPI Number	:	1508826702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHABBIR AHMED CHAUDHRY INC

Provider Business Mailing Address
First Line	:	5611 MOSTELLER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4137
Country	:	US
Telephone Number	:	405-843-2345
Fax Number	:	405-843-8237

Provider Business Practice Location Address
First Line	:	5611 MOSTELLER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4137
Country	:	US
Telephone Number	:	405-843-2345
Fax Number	:	405-843-8237

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHABBIR AHMED CHAUDHRY
Credential	:	MD
Telephone Number	:	405-843-2345

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/10/2014

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