Provider Demographics
NPI:1750327607
Name:CHACHANIDZE, VLADIMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:
Last Name:CHACHANIDZE
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 1:1331 UNION AVE STE 1008
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-7567
Mailing Address - Country:US
Mailing Address - Phone:901-881-3554
Mailing Address - Fax:901-425-9768
Practice Address - Street 1:1331 UNION AVE STE 1008
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7567
Practice Address - Country:US
Practice Address - Phone:901-881-3554
Practice Address - Fax:901-425-9768
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4827207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease