Individual
DR. MICHAEL RENE CHARDACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
617 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6223
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
52080611205
UT
207XX0801X
Orthopaedic Trauma Physician
5208061-1205
UT
Other
Enumeration date
05/30/2006
Last updated
03/02/2021
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