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General NPI Number Information
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NPI Number | 1821544081
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Entity Type | Individual
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Provider Name | IMAN CHAMAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 200 HEALTH PARK DR
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City | OWOSSO
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State | MI
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Zip | 48867-1291
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Country | US
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Telephone | 989-723-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HEALTH PARK DR
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City | OWOSSO
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State | MI
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Zip | 48867-1291
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Country | US
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Telephone | 989-723-8666
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MC4600816
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601007905
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License Number State | MI
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