Individual
MR. LOREN CHUDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 TOWN CENTER, SUITE 650, SOUTHFIELD, MI 48075
(248) 352-5851
(248) 352-5211
Mailing address
2000 TOWN CENTER, SUITE 650, SOUTHFIELD, MI 48075
(248) 430-5350
(248) 352-5211
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
LC012791
MI
207Q00000X
Family Medicine Physician
Primary
5101012791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114351390
—
MI
01
—
LC012791
BCBS
MI
Enumeration date
05/23/2006
Last updated
04/24/2014
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