Provider Demographics
NPI:1366920597
Name:CHAKRABORTI, ABHISHEK (MD)
Entity type:Individual
Prefix:DR
First Name:ABHISHEK
Middle Name:
Last Name:CHAKRABORTI
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 1:634 SW MULVANE ST.
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-4423
Mailing Address - Country:US
Mailing Address - Phone:785-295-9401
Mailing Address - Fax:785-295-9402
Practice Address - Street 1:634 SW MULVANE ST.
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-4423
Practice Address - Country:US
Practice Address - Phone:785-295-9401
Practice Address - Fax:785-295-9402
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS04-48977207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program