Individual
TIA CHAKRABORTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 MICHIGAN ST NE # MC019, GRAND RAPIDS, MI 49503-2560
(616) 486-0310
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
4301501463
MI
2084N0400X
Neurology Physician
4301501463
MI
Other
Enumeration date
07/15/2014
Last updated
08/08/2022
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