Individual
CHARLES ANDREW CHADAKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5380 S RAINBOW BLVD, LAS VEGAS, NV 89118-1877
(702) 845-2841
(702) 252-4405
Mailing address
7326 LARAMIE AVE, LAS VEGAS, NV 89113-3097
(702) 787-4867
(702) 614-9928
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1050
NV
363AS0400X
Surgical Physician Assistant
PA1050
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512583
—
NV
Enumeration date
07/16/2007
Last updated
04/07/2010
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