Individual
GLORIA CHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12871 E JEFFERSON AVE, DETROIT, MI 48215-2754
(313) 821-3900
(313) 821-1511
Mailing address
27774 FRANKLIN RD, SOUTHFIELD, MI 48034-2352
(248) 356-5555
(248) 356-5544
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101009530
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3221696-11
—
MI
Enumeration date
08/18/2005
Last updated
01/19/2012
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