Healthcare Provider Details

I. General information

NPI: 1427979665
Provider Name (Legal Business Name): CHIRON SPORTS PERFORMANCE AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43494 WOODWARD AVE STE 105
BLOOMFIELD HILLS MI
48302-5053
US

IV. Provider business mailing address

43494 WOODWARD AVE STE 105
BLOOMFIELD HILLS MI
48302-5053
US

V. Phone/Fax

Practice location:
  • Phone: 248-321-4810
  • Fax:
Mailing address:
  • Phone: 248-321-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHIBUZO OHANAJA
Title or Position: MEDICAL DIRECTOR
Credential: MD, MPH
Phone: 574-520-3551