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General NPI Number Information
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NPI Number | 1043690779
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Entity Type | Organization
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Legal Business Name | CHANDA J CORBIN, PLLC
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 174 S MAIN ST
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City | ROMEO
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State | MI
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Zip | 48065-5128
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Country | US
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Telephone | 586-752-2861
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Fax |
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Provider Business Mailing Address
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Address Line | 174 S MAIN ST
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City | ROMEO
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State | MI
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Zip | 48065-5128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHANDA CORBIN
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Credential | DPM
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Telephone | 586-337-9055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5901002094
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License Number State | MI
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