Healthcare Provider Details

I. General information

NPI: 1073549515
Provider Name (Legal Business Name): ARNAB CHAKRAVARTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W 10TH AVE FL 2
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8415
  • Fax: 614-293-4044
Mailing address:
  • Phone: 614-293-8415
  • Fax: 614-293-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.093620
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number202625
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: