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Organization

MICHAEL J CHARBONEAU JR DO PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL JOSEPH CHARBONEAU JR. DO (OWNER)
(734) 241-4245
Entity
Organization

Contact information

Practice address
730 N MACOMB ST, SUITE 329, MONROE, MI 48162-2900
(734) 241-4245
(734) 242-8903
Mailing address
730 N MACOMB ST, SUITE 329, MONROE, MI 48162-2900
(734) 241-4245
(734) 242-8903

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101010247
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0255810524
BLUE CROSS
MI
05
4218443
MI
Enumeration date
05/07/2008
Last updated
05/07/2008
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