MEDICARE: DR. SHAHID K CHOUDHARY M.D.

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	2084N0400X	Neurology Physician	104541	MO

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	:	1710906276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAHID K CHOUDHARY M.D.

Provider Business Mailing Address
First Line	:	3098 OAK GROVE RD
Second Line	:
City	:	POPLAR BLUFF
State	:	MO
Zip	:	63901-8938
Country	:	US
Telephone Number	:	573-778-2600
Fax Number	:	573-776-9002

Provider Business Practice Location Address
First Line	:	2210 BARRON RD STE 112
Second Line	:
City	:	POPLAR BLUFF
State	:	MO
Zip	:	63901-1908
Country	:	US
Telephone Number	:	573-785-0889
Fax Number	:	573-785-2011

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	02/10/2026

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