Provider Demographics
NPI:1821092305
Name:CHORAZY, PAULA ANN (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:CHORAZY
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 1:701 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7412
Mailing Address - Country:US
Mailing Address - Phone:989-895-9876
Mailing Address - Fax:989-895-9780
Practice Address - Street 1:16001 WEST NINE MILE ROAD
Practice Address - Street 2:DEPT OF CRITICAL CARE
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-849-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056407207RC0200X, 2080P0203X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI338726310Medicaid
MIG58164Medicare UPIN
MI0F36485020Medicare ID - Type UnspecifiedPROVIDER ID