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Contact Information

PHILIP S CHACKO
3200 MACCORKLE AVE SE
CHARLESTON, WV25304-1227
 Phone: 248-514-1520
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PHILIP S CHACKO · (Male)

NPI Number 1639707458
Status Active
Credentials
Entity Individual
Enumeration date 03/28/2020
Last updated 06/28/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • MI License # 5151014370
  • WV License # 4674
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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