Individual
JOE S CHOMCHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4851 E PICKARD ST STE 2700, MOUNT PLEASANT, MI 48858-2042
(989) 772-6848
(989) 317-9263
Mailing address
4851 E PICKARD ST STE 2700, MOUNT PLEASANT, MI 48858-2042
(989) 772-6848
(989) 317-9263
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
4301063374
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
4301063374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370081
BCBSM
MI
01
—
040016591
PALMETTO GBA
MI
05
—
4337981
—
MI
05
—
4645845
—
MI
Enumeration date
03/28/2006
Last updated
04/17/2020
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