Individual
KHALID CHAUDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 MOONBOW PLZ, CORBIN, KY 40701-8949
(606) 528-5331
(606) 528-3223
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21165
KY
207RC0000X
Cardiovascular Disease Physician
21165
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64211659
—
KY
01
—
C04002
CHI
KY
01
—
P01434922
RR MEDICARE
KY
Enumeration date
05/09/2006
Last updated
12/02/2020
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