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General NPI Number Information
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NPI Number | 1710912498
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Entity Type | Individual
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Provider Name | ROLAND F CHALIFOUX JR. DO
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 34025 HARPER AVE
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-3737
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Country | US
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Telephone | 586-445-9900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6115
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City | WHEELING
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State | WV
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Zip | 26003-0737
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Country | US
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Telephone | 304-242-4004
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Fax | 304-242-8004
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 5101009950
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 5101009950
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 2077
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 34.016792
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License Number State | OH
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