| Dr Chanchamma Thannikkary, MD | |
|
212 Smith Church Rd, Roanoke Rapids, NC 27870-4914 | |
| (252) 537-1717 | |
| (252) 537-1366 |
| Full Name | Dr Chanchamma Thannikkary |
|---|---|
| Gender | Female |
| Speciality | Radiology - Radiation Oncology |
| Location | 212 Smith Church Rd, Roanoke Rapids, North Carolina |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881654085 | NPI | - | NPPES |
| P01269393 | Other | NC | RAILROAD MCR |
| 1881654085 | Medicaid | NC | |
| 3722179 | Other | NC | CIGNA |
| 5760043 | Other | NC | AETNA |
| 1881654085 | Medicaid | VA | |
| 8982452 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 32057 (North Carolina) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Chanchamma Thannikkary, MD 2234 Colonial Blvd, Attn: Payer Contracting & Relations, Fort Myers, FL 33907-1412 Ph: (239) 931-7342 | Dr Chanchamma Thannikkary, MD 212 Smith Church Rd, Roanoke Rapids, NC 27870-4914 Ph: (252) 537-1717 |
Michael Dean Sorensen, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 212 Smith Church Rd, Roanoke Rapids, NC 27870 Phone: 252-537-1717 Fax: 252-537-1366 |