Provider Demographics
NPI:1851572879
Name:CHELSEA FAMILY PHYSICIANS PC
Entity Type:Organization
Organization Name:CHELSEA FAMILY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WASHBURN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-475-9800
Mailing Address - Street 1:1123 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1426
Mailing Address - Country:US
Mailing Address - Phone:734-475-9800
Mailing Address - Fax:734-475-0918
Practice Address - Street 1:1123 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1426
Practice Address - Country:US
Practice Address - Phone:734-475-9800
Practice Address - Fax:734-475-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMS029991261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1043351356OtherNPI DR SMITH
MI2809063Medicaid
MI1043351356OtherNPI DR SMITH
MI0H163446081Medicare PIN