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Individual

REBECCA GLORIA CHACKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(800) 653-6568
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
(488) 511-4302

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301117405
MI
207RH0003X
Hematology & Oncology Physician
Primary
4301117405
MI

Other

Enumeration date
06/07/2016
Last updated
06/02/2025
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