Provider Demographics
NPI:1023009057
Name:CHAMES, MICHAEL C (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:CHAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1015 LAURENCE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-2964
Mailing Address - Country:US
Mailing Address - Phone:517-787-0364
Mailing Address - Fax:517-787-2272
Practice Address - Street 1:1015 LAURENCE AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202
Practice Address - Country:US
Practice Address - Phone:517-787-0364
Practice Address - Fax:517-787-2272
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMC057919207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3913940002Medicare NSC
MI3913940001Medicare NSC
MI0C84729003Medicare PIN
MIG13778Medicare UPIN