Provider Demographics
NPI:1073872743
Name:CHAMBERLAIN, JUSTIN L (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:L
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:106 STEVENS CT
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8426
Mailing Address - Country:US
Mailing Address - Phone:910-326-6017
Mailing Address - Fax:
Practice Address - Street 1:IHA GENERAL SURGERY
Practice Address - Street 2:5325 ELLIOTT DRIVE SUITE 104
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-712-8150
Practice Address - Fax:734-887-8939
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2023-01-18
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Provider Licenses
StateLicense IDTaxonomies
MI4301100248208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery