Provider Demographics
NPI:1699190256
Name:CHOKSI, VIVEK KETAN (MD)
Entity Type:Individual
Prefix:
First Name:VIVEK
Middle Name:KETAN
Last Name:CHOKSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SINGLETON RIDGE ROAD, ATTENTION PATIENT ACCOUNTING
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-234-6946
Mailing Address - Fax:
Practice Address - Street 1:2376 CYPRESS CIR, STE 203
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8994
Practice Address - Country:US
Practice Address - Phone:843-347-6038
Practice Address - Fax:843-347-9808
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC85112207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program