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General NPI Number Information
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NPI Number | 1366476517
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Entity Type | Organization
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Legal Business Name | JOE S. CHOMCHAI, M.D., P.C.
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 2981 HEALTH PARKWAY SUITE C
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858
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Country | US
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Telephone | 989-772-6848
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Fax | 989-772-6817
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Provider Business Mailing Address
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Address Line | 2981 HEALTH PARKWAY SUITE C
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858
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Country | US
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Telephone | 989-772-6848
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Fax | 989-772-6817
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOE S CHOMCHAI
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Credential | M.D.
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Telephone | 989-772-6848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 4301063374
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License Number State | MI
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