Provider Demographics
NPI:1710306741
Name:CHATMAN, JASON (PA (ASCP))
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:CHATMAN
Suffix:
Gender:M
Credentials:PA (ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15669 NORTHVILLE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4905
Mailing Address - Country:US
Mailing Address - Phone:734-673-5608
Mailing Address - Fax:
Practice Address - Street 1:15669 NORTHVILLE FOREST DR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4905
Practice Address - Country:US
Practice Address - Phone:734-673-5608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI672207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology