Healthcare Provider Details

I. General information

NPI: 1083710107
Provider Name (Legal Business Name): JOHN WILLIAM CHATAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 AVIS DR STE 200
ANN ARBOR MI
48108-9649
US

IV. Provider business mailing address

710 AVIS DR STE 200
ANN ARBOR MI
48108-9649
US

V. Phone/Fax

Practice location:
  • Phone: 734-373-7246
  • Fax: 734-375-6585
Mailing address:
  • Phone: 734-373-7246
  • Fax: 734-375-6585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301051247
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number4301051247
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: