Individual
DR. CHARISE LANETTE VALENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4245 S BEECH DALY ST, SUITE 104, DEARBORN HEIGHTS, MI 48125-1567
(313) 730-9011
(313) 730-9013
Mailing address
4245 S BEECH DALY ST, SUITE 104, DEARBORN HEIGHTS, MI 48125-1567
(313) 730-9011
(313) 730-9013
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
CV053752
MI
208D00000X
General Practice Physician
Primary
CV053752
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306343272
BCBS PERSONAL
MI
05
—
4614876-10
—
MI
01
—
700H219440
BCBS
MI
Enumeration date
06/13/2006
Last updated
02/04/2011
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