Individual
BENJAMIN MICHAEL CHALSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1855 TANNER WAY STE 220, HARRIMAN, TN 37748-8332
(865) 882-2442
(865) 374-2123
Mailing address
1855 TANNER WAY STE 220, HARRIMAN, TN 37748-8332
(865) 882-2442
(865) 374-2123
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
5396
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q080780
—
TN
Enumeration date
01/11/2023
Last updated
06/04/2026
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