Individual
DR. CHAD LOUIS KLOCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, HENRY FORD HOSPITAL - DEPARTMENT OF MEDICAL EDUCATION, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 876-4806
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301103794
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/14/2013
Last updated
09/15/2023
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