Individual
MARAT G. CHAIKHOUTDINOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1513 VOORHIES AVE, SECOND FLOOR, BROOKLYN, NY 11235-3994
(718) 332-4440
(718) 332-5089
Mailing address
105 KINGS HWY, 5C, BROOKLYN, NY 11214-1525
(718) 513-4386
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
240497
NY
207Q00000X
Family Medicine Physician
A87766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A877660
—
CA
05
—
02823449
—
NY
Enumeration date
11/01/2006
Last updated
07/19/2012
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