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General NPI Number Information
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NPI Number | 1184716318
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Entity Type | Organization
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Legal Business Name | LOUIS CHIARA MD PC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 S MAIN ST SUITE D
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City | MILFORD
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State | MI
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Zip | 48381-1975
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Country | US
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Telephone | 248-684-1282
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Fax | 248-684-2485
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Provider Business Mailing Address
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Address Line | PO BOX 930319
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City | WIXOM
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State | MI
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Zip | 48393-0319
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Country | US
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Telephone | 248-684-1282
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Fax | 248-684-2485
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS C CHIARA
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Credential | M.D.
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Telephone | 248-684-1282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4301045542
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License Number State | MI
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