Individual
KONSTANTIN V CHERNUKHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-7237
(215) 707-9389
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7237
(215) 707-9389
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
C1-0010427
DE
2085R0202X
Diagnostic Radiology Physician
D0073496
MD
2085R0202X
Diagnostic Radiology Physician
Primary
MD419155
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0073496
LICENSE
MD
01
—
MD419155
MEDICAL LICENSE
PA
Enumeration date
10/25/2006
Last updated
08/13/2018
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