Provider Demographics
NPI:1508951633
Name:CHATMAN, SYLMARA EVELYN (MD)
Entity Type:Individual
Prefix:
First Name:SYLMARA
Middle Name:EVELYN
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6689 ORCHARD LAKE RD
Mailing Address - Street 2:STE 339
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17603 WEST TEN MILE ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-569-8420
Practice Address - Fax:248-569-8565
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI055117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3220151Medicaid
MI3220151Medicaid
OM85830Medicare ID - Type Unspecified