Healthcare Provider Details

I. General information

NPI: 1104897107
Provider Name (Legal Business Name): MICHELLE CHARTIER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 M 119
HARBOR SPRINGS MI
49740-9816
US

IV. Provider business mailing address

1105 SIXTH ST
TRAVERSE CITY MI
49684-2386
US

V. Phone/Fax

Practice location:
  • Phone: 231-347-5400
  • Fax: 231-348-2515
Mailing address:
  • Phone:
  • Fax: 734-789-1520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101013074
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: