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Individual

CRAIG LAMARR CHATMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
327 DEWEY AVE, BUFFALO, NY 14214-2533
(716) 713-5557
Mailing address
327 DEWEY AVE, BUFFALO, NY 14214-2533
(716) 381-6091

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
882150685
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12121963
NY
Enumeration date
03/10/2021
Last updated
03/10/2021
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