Provider Demographics
NPI:1619174505
Name:CHALMERS, RICHARD JORDAN (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JORDAN
Last Name:CHALMERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36500 S GRATIOT AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-1772
Mailing Address - Country:US
Mailing Address - Phone:586-493-3727
Mailing Address - Fax:
Practice Address - Street 1:36500 S GRATIOT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1772
Practice Address - Country:US
Practice Address - Phone:586-493-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017320207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine