Provider Demographics
NPI:1467630954
Name:PARRIS, TCHAIKO M (MD)
Entity Type:Individual
Prefix:DR
First Name:TCHAIKO
Middle Name:M
Last Name:PARRIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1789 SHAWANO AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-3243
Mailing Address - Country:US
Mailing Address - Phone:920-499-1428
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:744 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3505
Practice Address - Country:US
Practice Address - Phone:920-433-3643
Practice Address - Fax:920-431-5635
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2023-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI20901-8752085R0202X
WI817392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467630954OtherAMERICAN BOARD OF RADIOLOGY/DIAGNOSTIC RADIOLOGY