| Achankunju A Chacko Md Llc | |
|
7610 Carroll Ave Suite 390 Takoma Park MD 20912-6384 | |
| (301) 270-5522 | |
| (301) 270-4837 |
| Full Name | Achankunju A Chacko Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7610 Carroll Ave, Takoma Park, Maryland |
| Authorized Official Name and Position | Achankunju A Chacko (MD) |
| Authorized Official Contact | 3012705522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Achankunju A Chacko Md Llc 7610 Carroll Ave Suite 390 Takoma Park MD 20912-6384 Ph: (301) 270-5522 | Achankunju A Chacko Md Llc 7610 Carroll Ave Suite 390 Takoma Park MD 20912-6384 Ph: (301) 270-5522 |
| NPI Number | 1801189055 |
|---|---|
| Provider Enumeration Date | 05/20/2011 |
| Last Update Date | 05/20/2011 |
| Medicare PECOS PAC ID | 7719164946 |
|---|---|
| Medicare Enrollment ID | O20110615000447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801189055 | NPI | - | NPPES |
| 7959214000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | D20129 (Maryland) | Primary |
| Provider Name | Achankunj Chacko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508878414 PECOS PAC ID: 0244417475 Enrollment ID: I20110615000481 |
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