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General NPI Number Information
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NPI Number | 1609569169
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Entity Type | Organization
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Legal Business Name | CH MSSP SERVICES MI PLLC
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 400 RENAISSANCE CTR STE 2600
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City | DETROIT
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State | MI
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Zip | 48243-1599
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Country | US
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Telephone | 337-408-0797
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 JOHNSTON ST STE 205
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City | LAFAYETTE
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State | LA
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Zip | 70503-5345
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Country | US
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Telephone | 337-408-0797
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Fax | 337-943-0846
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Authorized Official
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Title or Position | SR VP OF ADMINISTRATIVE SERVICES
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Name | NICOLE HOWARD
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Credential |
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Telephone | 337-408-0797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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