PHILIP SONI CHACKO

CHARLESTON, WV
NPI1639707458
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: WV  4674)
Additional Taxonomies208600000X Surgery
(Licence: MI  5151014370)
Enumeration Date2020-03-28
Last Update Date2025-06-28
Business Address
PHILIP SONI CHACKO
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304-1227
Phone number: 248-514-1520
Mailing Address
PHILIP SONI CHACKO
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304-1227
Phone number: