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Individual
STEPHEN BLAISE CHROMIAK
Active
Individual
STEPHEN BLAISE CHROMIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
00017665
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MAIN GROUP MEDICARE PAYEE NUMBER
AL
01
—
1063439065
MAIN GROUP NPI PAYEE NUMBER
AL
01
—
17665
MEDICAL LICENSE
AL
01
—
511-17876
BC
AL
05
—
630000013
—
AL
Enumeration date
04/26/2006
Last updated
01/31/2014
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