Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | PC004238 | MI |
NPI | 1609950419 |
---|---|
Provider Name | Patrick E Chase |
First Address | Saint Clair Shores, MI 48081-1200 |
Second Address | Saint Clair Shores, MI 48081-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/11/2007 |