Provider Demographics
NPI:1730419672
Name:CHALKIAS, SPYRIDON (MD)
Entity type:Individual
Prefix:
First Name:SPYRIDON
Middle Name:
Last Name:CHALKIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RIDGEFIELD AVE
Mailing Address - Street 2:UNIT 406
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-3103
Mailing Address - Country:US
Mailing Address - Phone:203-873-1296
Mailing Address - Fax:
Practice Address - Street 1:267 GRANT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2805
Practice Address - Country:US
Practice Address - Phone:203-534-5079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-26
Last Update Date:2009-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program