Basic Information
Provider Information
NPI: 1770875817
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOWDHURY
FirstName: MONZURUL
MiddleName: H
NamePrefix: DR.
NameSuffix:  
Credential: M.D., M.R.C.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 415348
Address2:  
City: BOSTON
State: MA
PostalCode: 022415348
CountryCode: US
TelephoneNumber: 8002258885
FaxNumber: 5083341977
Practice Location
Address1: 157 UNION ST
Address2:  
City: MARLBOROUGH
State: MA
PostalCode: 017521228
CountryCode: US
TelephoneNumber: 5084865678
FaxNumber: 5084865677
Other Information
ProviderEnumerationDate: 05/09/2011
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X052690CTN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X270496MAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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