Individual
DR. CHETAN VAGESH HAMPOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2310 VILLAGE SQUARE PKWY STE 204, FLEMING ISLAND, FL 32003-6409
(904) 224-5185
(904) 376-3202
Mailing address
PO BOX 746652, ATLANTA, GA 30374-6652
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125-051072
IL
207R00000X
Internal Medicine Physician
35-095464
OH
207R00000X
Internal Medicine Physician
ME142908
FL
207RC0000X
Cardiovascular Disease Physician
35-095464
OH
207RC0000X
Cardiovascular Disease Physician
Primary
ME142908
FL
207RI0011X
Interventional Cardiology Physician
35095464
OH
207RI0011X
Interventional Cardiology Physician
ME142908
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105563400
—
FL
05
—
3025372
—
OH
Enumeration date
03/29/2010
Last updated
01/24/2025
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