Provider Demographics
NPI:1306845664
Name:TCHOUKINA, INNA FAIS (MD)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:FAIS
Last Name:TCHOUKINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:INNA
Other - Middle Name:FAIS
Other - Last Name:CHUKINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:IM: CARD: CHF-TRANSPLANT
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-9989
Practice Address - Fax:804-828-3544
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237296207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2589629OtherGHIPPO
VAI31708Medicare UPIN
VA007705E66Medicare PIN
VAP00233674Medicare PIN
NC5901089Medicaid
VA1306845664Medicaid
VA2134048OtherMAMSI
VA010158184Medicaid
VA186316OtherBCBS