Individual
MICHAEL GEORGE CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
761 MAIN AVE STE 201, NORWALK, CT 06851-1176
(203) 838-4000
(203) 845-9535
Mailing address
761 MAIN AVE STE 201, NORWALK, CT 06851-1176
(203) 838-4000
(203) 845-9535
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4449
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4449
CT LICENSE
CT
Enumeration date
06/06/2019
Last updated
06/06/2019
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