Individual
JACOB M CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
AUGUSTA MEDICAL CENTER ANESTHESIA DEPT, 78 MEDICAL CENTER DRIVE, FISHERSVILLE, VA 22939
(540) 427-4406
(540) 427-4915
Mailing address
PO BOX 890580, CHARLOTTE, NC 28289-0580
(540) 427-4406
(540) 427-4915
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
047726
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922036094
—
VA
Enumeration date
06/29/2006
Last updated
11/30/2022
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