Individual provider · Type 1 NPI

Sumy Chacko, PA-C

Surgical Physician Assistant · Olney, MD

NPI number 1508909045 Active

Practice location

18101 Prince Philip Dr
Olney, MD 20832-1514

Call (301) 774-4105 Map

Mailing address

2429 Epstein Ct
Brookeville, MD 20833-3263

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X011290 (NY)
Surgical Physician Assistant Primary 363AS0400XC0004157 (MD)

Surgical Physician Assistant: Definition to come...

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About NPI 1508909045

Sumy Chacko, PA-C's National Provider Identifier is 1508909045, issued on Feb 15, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Olney, MD. The record was last updated on Mar 30, 2010.