Provider Demographics
NPI:1790218808
Name:PFENNING, POORVI CHHABRA (MD)
Entity Type:Individual
Prefix:MRS
First Name:POORVI
Middle Name:CHHABRA
Last Name:PFENNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 SHAKERAG HL
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3365
Mailing Address - Country:US
Mailing Address - Phone:404-251-2150
Mailing Address - Fax:
Practice Address - Street 1:3000 SHAKERAG HL
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3365
Practice Address - Country:US
Practice Address - Phone:404-251-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0061178207Q00000X
GA91176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine