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1871598185

NPI Code Detail

MEDICARE: WILLIAM MOOWAN CHAE M.D.

MEDICARE: WILLIAM MOOWAN CHAE M.D.

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
1	2085R0202X	Diagnostic Radiology Physician	4301031376	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	300008866	OTHER		PALMETTO GBA RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0Q26008011	OTHER		FED BLACK LUNG PROGRAM
4	0H26188	OTHER	MI	BCBS PROVIDER NUMBER
5	136661110	OTHER	MI	PROCARE
6	0H26188011	OTHER		FED BLACK LUNG PROGRAM
7	110479	OTHER	MI	GREAT LAKES HEALTH
8	0Q26008	OTHER	MI	BCBS PROVIDER NUMBER
9	1006439	OTHER	MI	MCLAREN HEALTH

General Provider Information

NPI Number	:	1871598185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MOOWAN CHAE M.D.

Provider Business Mailing Address
First Line	:	36175 HARPER AVE
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48035-3274
Country	:	US
Telephone Number	:	586-741-3772
Fax Number	:	586-741-4600

Provider Business Practice Location Address
First Line	:	36175 HARPER AVE
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48035-3274
Country	:	US
Telephone Number	:	586-741-3772
Fax Number	:	586-741-4600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/14/2011

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Directions to “ WILLIAM MOOWAN CHAE M.D.” Practice Location

Language	Start Address	Practice Location

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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