Individual
DR. TINATIN CHABRASHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST # C525, PHILADELPHIA, PA 19140-5103
(301) 520-5549
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(301) 520-5549
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
000771
GA
2084N0400X
Neurology Physician
MD435242
PA
2085R0001X
Radiation Oncology Physician
Primary
59408
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000771
RESIDENCY TRAINING PERMIT
GA
01
—
MD435242
MEDICAL LICENCE NUMBER
PA
Enumeration date
01/28/2008
Last updated
05/09/2017
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