Healthcare Provider Details

I. General information

NPI: 1720177561
Provider Name (Legal Business Name): DENNIS KARL CHERNIN M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 S HURON PKWY
ANN ARBOR MI
48104-5124
US

IV. Provider business mailing address

1700 IVES LN
ANN ARBOR MI
48104-4501
US

V. Phone/Fax

Practice location:
  • Phone: 734-973-3030
  • Fax: 734-973-3057
Mailing address:
  • Phone: 734-662-2353
  • Fax: 734-662-2353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number4301043276
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: