Provider Demographics
NPI:1669540621
Name:DUCHARME CHIROPRACTIC CENTER P.C.
Entity type:Organization
Organization Name:DUCHARME CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DUCHARME
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-652-8686
Mailing Address - Street 1:111 ROCHDALE DR S
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2274
Mailing Address - Country:US
Mailing Address - Phone:248-652-8686
Mailing Address - Fax:248-601-2933
Practice Address - Street 1:111 ROCHDALE DR S
Practice Address - Street 2:SUITE B
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-2274
Practice Address - Country:US
Practice Address - Phone:248-652-8686
Practice Address - Fax:248-601-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP15580Medicare PIN