MEDICARE: INNA FAIS TCHOUKINA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	0101237296	VA
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	0101237296	VA

General Provider Information

NPI Number	:	1306845664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INNA FAIS TCHOUKINA MD

Provider Business Mailing Address
First Line	:	PO BOX 91734
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23291-1734
Country	:	US
Telephone Number	:	804-358-6100
Fax Number	:	804-342-7619

Provider Business Practice Location Address
First Line	:	1250 E MARSHALL ST
Second Line	:	IM: CARD: CHF-TRANSPLANT
City	:	RICHMOND
State	:	VA
Zip	:	23298-5051
Country	:	US
Telephone Number	:	804-828-9989
Fax Number	:	804-828-3544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	12/30/2022

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Directions to “ INNA FAIS TCHOUKINA MD” Practice Location

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