Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 2901018548 | MI |
NPI | 1043343791 |
---|---|
Provider Name | Dr. Steven W Charchut |
First Address | Lansing, MI 48917-4086 |
Second Address | Lansing, MI 48917-4086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |