Individual
DR. KALAPPURACKAL CHACKO JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 CROOKS RD, STE 100, TROY, MI 48084-4733
(248) 740-9360
(248) 740-9374
Mailing address
2525 CROOKS RD, STE 100, TROY, MI 48084-4733
(248) 740-9360
(248) 740-9374
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
KJ 050850
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2902630
—
MI
Enumeration date
10/09/2006
Last updated
04/19/2016
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