Provider Demographics
NPI:1225236946
Name:CHAMBERS, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1133 JOHN FREEMAN BLVD.
Mailing Address - Street 2:JJL S80-10
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2809
Mailing Address - Country:US
Mailing Address - Phone:713-500-6325
Mailing Address - Fax:713-500-0706
Practice Address - Street 1:1133 JOHN FREEMAN BLVD.
Practice Address - Street 2:JJL S80-10
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2809
Practice Address - Country:US
Practice Address - Phone:713-500-6325
Practice Address - Fax:713-500-0706
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG73588207Q00000X
FLME97508207Q00000X
GA063766207Q00000X, 207Q00000X
MS22886207Q00000X
GA637662083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0256332Medicaid
1225236946OtherNPI
G73588OtherMEDICAL BOARD OF CALIFORNIA
MS22886OtherMISSISSIPPI MEDICAL LICENSE
ME97508OtherMEDICAL BOARD OF FLORIDA
G73588OtherMEDICAL BOARD OF CALIFORNIA
MS22886OtherMISSISSIPPI MEDICAL LICENSE
G73588OtherMEDICAL BOARD OF CALIFORNIA