1396747549 NPI number — IMRAN H CHOWDHURY MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396747549 NPI number — IMRAN H CHOWDHURY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOWDHURY
Provider First Name:
IMRAN
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396747549
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9784 OLD ANNAPOLIS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21042-6327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-997-1336
Provider Business Mailing Address Fax Number:
410-997-1636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10802 HICKORY RIDGE RD
Provider Second Line Business Practice Location Address:
STE 310
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-3622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-997-1336
Provider Business Practice Location Address Fax Number:
410-997-1636
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0042019 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0178052 . This is a "GHI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1854746 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: N1510001 . This is a "BLUE CROSS FEDERAL" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1013393 . This is a "COVENTRY" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5702 . This is a "ELDER HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 88624 . This is a "AMERICAID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 92-00121 . This is a "EVERCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1114986 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 328881100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4564479 . This is a "AETNA OTHER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P00288291 . This is a "RAILROAD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1936481 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 244618 . This is a "BLUE CROSS OF TRIGON" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 459053 . This is a "ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 61077802 . This is a "BLUE CROSS OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 770390 . This is a "NATIONAL CAPITAL PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 88624 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 099956794A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 027476300 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4410647001 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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