MEDICARE: DR. SATISH KUMAR CHAM MD

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	207Q00000X	Family Medicine Physician	4301040701	MI
2	2084P0800X	Psychiatry Physician	4301040701	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	382507138	OTHER	MI	TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2648200032	OTHER	MI	BCBS PROVIDER ID

General Provider Information

NPI Number	:	1962472654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SATISH KUMAR CHAM MD

Provider Business Mailing Address
First Line	:	4530 ECHO RD
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-1951
Country	:	US
Telephone Number	:	313-587-5580
Fax Number	:

Provider Business Practice Location Address
First Line	:	22170 W 9 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-6007
Country	:	US
Telephone Number	:	248-475-6800
Fax Number	:	248-355-1402

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	01/30/2014

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