Individual
STEPHEN BLAISE CHROMIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8847
(251) 690-8859
Mailing address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8847
(251) 690-8859
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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