Individual
DR. SHUSHOVAN CHAKRABORTTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 N PARK BLVD STE 201, LAKE ORION, MI 48362-3189
(248) 929-8165
(248) 929-8930
Mailing address
425 N PARK BLVD STE 201, LAKE ORION, MI 48362-3189
(248) 929-8165
(248) 929-8930
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301076099
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
4301076099
MI
Other
Enumeration date
07/31/2006
Last updated
12/06/2018
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