Individual
SHIKHA REBECCA CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
505 IRVIN CT STE 200, DECATUR, GA 30030-1780
(404) 778-0640
(404) 299-7499
Mailing address
505 IRVIN CT STE 200, DECATUR, GA 30030-1780
(404) 778-0640
(404) 299-7499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
004024
GA
207R00000X
Internal Medicine Physician
Primary
67541
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124839
—
GA
Enumeration date
04/09/2009
Last updated
06/23/2022
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