Individual
MR. CHAKA CHIPAWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
9178 HIGHLAND RD, WHITE LAKE, MI 48386-4619
(248) 698-1999
Mailing address
1136 CARPENTER DR, PONTIAC, MI 48340-3313
(269) 277-0952
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704249478
MI
363LG0600X
Gerontology Nurse Practitioner
4704249478
MI
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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