Healthcare Provider Details

I. General information

NPI: 1386655132
Provider Name (Legal Business Name): CHOCK TSERING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 ELLEN ST
MONROE NC
28112-5173
US

IV. Provider business mailing address

PO BOX 734
MONROE NC
28111-0734
US

V. Phone/Fax

Practice location:
  • Phone: 704-283-8811
  • Fax: 866-339-8381
Mailing address:
  • Phone: 704-283-8811
  • Fax: 704-283-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number200100798
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: