MEDICARE: DR. KAUSHAL SHAMBHUBHAI CHAUDHARI 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	207Q00000X	Family Medicine Physician	51510	TN
2	207Q00000X	Family Medicine Physician	72196	GA

General Provider Information

NPI Number	:	1750680104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAUSHAL SHAMBHUBHAI CHAUDHARI M.D.

Provider Business Mailing Address
First Line	:	4976 ALPHA LN
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-5470
Country	:	US
Telephone Number	:	423-497-5355
Fax Number	:	423-308-0281

Provider Business Practice Location Address
First Line	:	3063 BATTLEFIELD PKWY
Second Line	:
City	:	FORT OGLETHORPE
State	:	GA
Zip	:	30742-4003
Country	:	US
Telephone Number	:	706-841-7274
Fax Number	:	706-841-0434

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

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	04/06/2023

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