MEDICARE: DR. PRABIR K CHAUDHURI 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	208600000X	Surgery Physician	35053332	OH
2	2086X0206X	Surgical Oncology Physician	35053332	OH

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	:	1821092743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRABIR K CHAUDHURI M.D.

Provider Business Mailing Address
First Line	:	4510 DORR ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-4040
Country	:	US
Telephone Number	:	419-383-4025
Fax Number	:	419-383-6235

Provider Business Practice Location Address
First Line	:	1325 CONFERENCE DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-8009
Country	:	US
Telephone Number	:	419-383-6644
Fax Number	:	419-383-2924

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/30/2020

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