Individual
ACHANKUNJU A CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7610 CARROLL AVE, SUITE # 390, TAKOMA PARK, MD 20912-6384
(301) 270-5522
(301) 270-4837
Mailing address
7610 CARROLL AVE, SUITE # 390, TAKOMA PARK, MD 20912-6384
(301) 270-5522
(301) 270-4837
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
D20129
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7959214000
—
MD
Enumeration date
08/12/2006
Last updated
07/08/2007
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