Organization
CHAIRAT CHOMCHAI M.D P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAIRAT CHOMCHAI M.D. (PRESIDENT)
(586) 751-4230
Entity
Organization
Contact information
Practice address
28111 HOOVER RD, SUITE 6A, WARREN, MI 48093-4153
(586) 751-4230
(586) 751-9260
Mailing address
28111 HOOVER RD, SUITE 6A, WARREN, MI 48093-4153
(586) 751-4230
(586) 751-9260
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
4301032652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0507655
BCBSM
MI
Enumeration date
02/21/2010
Last updated
02/21/2010
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