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General NPI Number Information
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NPI Number | 1770637753
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Entity Type | Individual
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Provider Name | CHAIRAT CHOMCHAI MD
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 01/25/2026
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Provider Practice Location Address
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Address Line | 28111 HOOVER ROAD SUITE 6A
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City | WARREN
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State | MI
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Zip | 48093
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Country | US
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Telephone | 586-751-4230
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Fax | 586-751-9260
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Provider Business Mailing Address
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Address Line | 28111 HOOVER ROAD SUITE 6A
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City | WARREN
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State | MI
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Zip | 48093
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Country | US
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Telephone | 586-751-4230
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Fax | 586-751-9260
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 4301032652
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License Number State | MI
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