Provider Demographics
NPI:1144325697
Name:V CHOKKAVELU MD INC
Entity type:Organization
Organization Name:V CHOKKAVELU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VASANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOKKAVELU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-433-4523
Mailing Address - Street 1:66761 ANNA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9241
Mailing Address - Country:US
Mailing Address - Phone:740-433-4523
Mailing Address - Fax:740-433-4523
Practice Address - Street 1:66761 ANNA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9241
Practice Address - Country:US
Practice Address - Phone:740-433-4523
Practice Address - Fax:740-433-4523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0011152000Medicaid
OH2070191Medicaid
WV0011152000Medicaid
WVVC9299242Medicare PIN