Provider Demographics
NPI:1003828021
Name:NOOHANI, CHHAVI V (DO)
Entity type:Individual
Prefix:
First Name:CHHAVI
Middle Name:V
Last Name:NOOHANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHHAVI
Other - Middle Name:VIG
Other - Last Name:NOOHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:900 TOWNE LAKE PKWY
Mailing Address - Street 2:STE. 104
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1600
Mailing Address - Country:US
Mailing Address - Phone:770-639-5880
Mailing Address - Fax:770-693-5902
Practice Address - Street 1:900 TOWNE LAKE PKWY
Practice Address - Street 2:STE. 104
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1600
Practice Address - Country:US
Practice Address - Phone:770-639-5880
Practice Address - Fax:770-693-5902
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9536207Q00000X
GA66974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274065600Medicaid
FL30712OtherBCBS
P00387710OtherRAILROAD MEDICARE
FL274065600Medicaid
P00387710OtherRAILROAD MEDICARE
FLU6337ZMedicare PIN