| Doctor Name: | CAROL LYNN CHODUN |
| NPI Number: | 1265742704 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ACNP-BC |
| License Number: | 4704229927 |
| Business Practice Address: | 24211 Little Mack Avenue Eastlake Cardiovascular St Clair Shores, MI - 48080 |
| Business Phone Number: | 5864980440 |
| Business Fax Number: | 5864980401 |
| Mailing Address: | 24211 Little Mack Ave, Eastlake Cardiovascular ST CLAIR SHORES |
| State: | MI |
| Postal Code: | 48080 |
| Phone Number: | 5864980440 |
| Fax Number: | 5864980401 |
| NPI Enumeration Date: | 10/18/2010 |
| NPI Last Update Date: | 11/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 4704229927 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |