Individual
DR. JITHENDRA P CHOUDARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 REID PKWY, SUITE 210, RICHMOND, IN 47374-1157
(765) 962-1337
(765) 966-0858
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 962-1337
(765) 966-0858
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
01065734A
IN
207RI0011X
Interventional Cardiology Physician
35.074059
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000676851
ANTHEM
—
05
—
200442130
—
IN
05
—
2262279
—
OH
Enumeration date
08/16/2005
Last updated
05/13/2021
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