Healthcare Provider Details

I. General information

NPI: 1215039714
Provider Name (Legal Business Name): RAJINDER CHHOKAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MANCHESTER EXPY STE 1001 BUTLER PAVILION
COLUMBUS GA
31904-6802
US

IV. Provider business mailing address

2300 MANCHESTER EXPY STE 1001 BUTLER PAVILION
COLUMBUS GA
31904-6802
US

V. Phone/Fax

Practice location:
  • Phone: 706-322-0528
  • Fax: 706-322-2080
Mailing address:
  • Phone: 706-322-0528
  • Fax: 706-322-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number021486
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number021486
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number021486
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: