Provider Demographics
NPI:1497405203
Name:CATALINE, CHASE WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:WILLIAM
Last Name:CATALINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:CHASE
Other - Middle Name:WILLIAM
Other - Last Name:WAYNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22201 MOROSS RD STE 370
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2176
Mailing Address - Country:US
Mailing Address - Phone:313-343-4585
Mailing Address - Fax:313-343-7126
Practice Address - Street 1:22201 MOROSS RD STE 370
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2176
Practice Address - Country:US
Practice Address - Phone:313-343-4585
Practice Address - Fax:313-343-7126
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program