Organization Name: | CHANDA J CORBIN, PLLC |
NPI Number: | 1043690779 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHANDA CORBIN (OWNER) |
Mailing Address: | 239 S Main St Romeo |
State: | MI US |
Postal Code: | 480655130 |
Phone Number: | 5867522861 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2015 |
NPI Last Update Date: | 06/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 5901002094 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |