Individual
DR. MICHAEL B CHANCELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3471 5TH AVE, LKB SUITE 700, PITTSBURGH, PA 15213-3215
(412) 692-4100
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD041546L
PA
208800000X
Urology Physician
4301048056
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001271296
—
PA
Enumeration date
02/06/2006
Last updated
10/23/2020
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