Provider Demographics
NPI:1245263698
Name:CHEST SPECIALISTS, P.C.
Entity type:Organization
Organization Name:CHEST SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAUTBORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:258-737-8261
Mailing Address - Street 1:7399 MIDDLEBELT RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4137
Mailing Address - Country:US
Mailing Address - Phone:248-737-8261
Mailing Address - Fax:248-737-5115
Practice Address - Street 1:7399 MIDDLEBELT RD
Practice Address - Street 2:SUITE 3
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4137
Practice Address - Country:US
Practice Address - Phone:248-737-8261
Practice Address - Fax:248-737-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4302027320207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47410Medicare UPIN
MI6639860Medicare ID - Type Unspecified