Provider Demographics
NPI:1740604941
Name:GUNACHELVAN, KARTHIK
Entity type:Individual
Prefix:DR
First Name:KARTHIK
Middle Name:
Last Name:GUNACHELVAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 POST RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5936
Mailing Address - Country:US
Mailing Address - Phone:203-655-8749
Mailing Address - Fax:203-656-0701
Practice Address - Street 1:1500 POST RD STE 100
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5936
Practice Address - Country:US
Practice Address - Phone:203-655-8749
Practice Address - Fax:203-656-0701
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT82825207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110117532/AMedicaid
MA110117532/AMedicaid