Individual
MARIA CHULKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0976
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5353
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
0101281922
VA
390200000X
Student in an Organized Health Care Education/Training Program
4351045027
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2016
Last updated
08/20/2024
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