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General NPI Number Information
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NPI Number | 1811092166
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Entity Type | Organization
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Legal Business Name | CHAYA KENKRE, MD., PLLC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5301 E HURON RIVER DR ST. JOSEPH MERCY HOSPITAL
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 734-761-8439
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 130146
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City | ANN ARBOR
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State | MI
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Zip | 48113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDNET
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Name | MS. CHAYA KENKRE
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Credential | M.D.,
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Telephone | 734-761-8439
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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 | 4301075666
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License Number State | MI
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