Healthcare Provider Details

I. General information

NPI: 1780069948
Provider Name (Legal Business Name): CHAD BARCHESKI HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 44TH ST SW STE 400
WYOMING MI
49519-6836
US

IV. Provider business mailing address

2660 44TH ST SW STE 400
WYOMING MI
49519-6836
US

V. Phone/Fax

Practice location:
  • Phone: 616-530-8100
  • Fax: 616-530-8855
Mailing address:
  • Phone: 616-530-8100
  • Fax: 616-530-8855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3502007934
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: