Provider Demographics
NPI:1194726232
Name:CHACHAS, ANGELO GREGORY (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:GREGORY
Last Name:CHACHAS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100253
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 E 3900 S
Practice Address - Street 2:STE 460
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1348
Practice Address - Country:US
Practice Address - Phone:801-262-3564
Practice Address - Fax:801-262-3613
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT5951382-1205208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery