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Individual

ASHISH K CHAKRAVARTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1260 UNIVERSITY AVE, SEWANEE, TN 37375-2303
(931) 598-5691
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
030804
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18053
TLC TENNCARE
TN
01
3122069
BLUE CROSS
TN
05
3728385
TN
05
3835180
TN
05
3835185
TN
05
3835189
TN
01
4151492
BLUE CROSS
TN
01
P00384383
MEDICARE RAILROAD
TN
Enumeration date
05/25/2006
Last updated
11/06/2007
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