Individual
DR. GARY CHODOROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30100 TELEGRAPH RD, SUITE 177, BINGHAM FARMS, MI 48025-4560
(248) 647-1470
(248) 647-1472
Mailing address
30100 TELEGRAPH RD, SUITE 177, BINGHAM FARMS, MI 48025-4514
(248) 647-1470
(248) 647-1472
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
GC046805
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0633719
BLUE CARE NETWORK
MI
01
—
101420
PREFERRED CHOICE
MI
01
—
1106337
BLUE CROSS BLUE SHIELD
MI
01
—
250F334790
BLUE CROSS BLUE SHIELD
MI
01
—
4052753
AETNA
MI
01
—
49558
HAP THRU PROVIDENCE
MI
01
—
C3352
MCARE
MI
Enumeration date
07/16/2006
Last updated
10/13/2011
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