Basic Information
| Provider Information | |||||||||
| NPI: | 1811563075 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAUDHRY | ||||||||
| FirstName: | FARHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3670 WOODWARD AVE APT 212 | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149244789 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4201 ST ANTOINE ST | ||||||||
| Address2: | DETROIT MEDICAL CENTER GME OFFICE | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137455146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2021 | ||||||||
| LastUpdateDate: | 05/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 4351048593 | MI | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.