MEDICARE: MEDIHA BASHIR CHAUDHRY DO

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	OT020029	PA
2	207Q00000X	Family Medicine Physician	OS022716	PA

General Provider Information

NPI Number	:	1750905022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEDIHA BASHIR CHAUDHRY DO

Provider Business Mailing Address
First Line	:	PO BOX 13579
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-3579
Country	:	US
Telephone Number	:	484-628-1324
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 SECOND AVE
Second Line	:
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-2658
Country	:	US
Telephone Number	:	484-961-8220
Fax Number	:

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

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	04/18/2024

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