Individual
GEORGE CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4427
(215) 291-3000
Mailing address
PO BOX 8500-1776, PHILADELPHIA, PA 19178-0001
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD-073105-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1853138
—
PA
Enumeration date
06/27/2005
Last updated
07/08/2007
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