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NPI Code Detail

MEDICARE: CHELSEA PROFESSIONAL SERVICES

MEDICARE: CHELSEA PROFESSIONAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1689061426
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHELSEA PROFESSIONAL SERVICES
Provider Business Mailing Address
First Line : 775 S MAIN ST
Second Line :
City : CHELSEA
State : MI
Zip : 48118-1383
Country : US
Telephone Number : 734-593-5728
Fax Number : 734-475-6819
Provider Business Practice Location Address
First Line : 107 CHICAGO ST
Second Line :
City : BROOKLYN
State : MI
Zip : 49230-9703
Country : US
Telephone Number : 517-592-3275
Fax Number : 517-592-2540
Authorized Official
Title or Position : EXECUTIVE DIRECTOR/PHYSICIAN SVCS
Name : MR. DAVID CLAYTON
Credential :
Telephone Number : 734-593-5709
Provider Enumeration Date : 04/20/2015
Last Update Date : 07/14/2015

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Directions to “CHELSEA PROFESSIONAL SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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