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General NPI Number Information
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NPI Number | 1679953996
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Entity Type | Individual
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Provider Name | JORGE ALCHAMMAS
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Gender | Male
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 48709 VAN DYKE AVE
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-2562
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Country | US
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Telephone | 586-383-4702
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Fax |
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Provider Business Mailing Address
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Address Line | 48709 VAN DYKE AVE
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-2562
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Country | US
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Telephone | 586-822-8170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4301107571
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | MD61036738
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License Number State | WA
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