| 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 |
| 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 |