Shah Alam Chowdhury, MD | |
2490 Central Ave, Lake Station, IN 46405-2122 | |
(219) 763-8112 | |
(219) 764-5384 |
Full Name | Shah Alam Chowdhury |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2490 Central Ave, Lake Station, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578563516 | NPI | - | NPPES |
200290410 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 01049484A (Indiana) | Primary |
Entity Name | Northshore Health Centers Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114257300 PECOS PAC ID: 5799671236 Enrollment ID: O20040827000220 |
Entity Name | Community Healthnet Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952332298 PECOS PAC ID: 6305852344 Enrollment ID: O20060228000318 |
Entity Name | Franciscan Physician Network |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225327984 PECOS PAC ID: 3072790682 Enrollment ID: O20110608000486 |
Mailing Address | Practice Location Address |
---|---|
Shah Alam Chowdhury, MD Po Box 1430, Portage, IN 46368-9230 Ph: (219) 763-8112 | Shah Alam Chowdhury, MD 2490 Central Ave, Lake Station, IN 46405-2122 Ph: (219) 763-8112 |
Saoussan Alfahel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2490 Central Ave, Lake Station, IN 46405 Phone: 219-763-8112 Fax: 219-962-1808 | |
Wanda Averhart, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2490 Central Ave, Lake Station, IN 46405 Phone: 216-764-5399 | |
Dr. Ramadevi Sankaran, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2490 Central Ave, Lake Station, IN 46405 Phone: 219-763-8112 Fax: 219-962-1580 |