Provider Demographics
NPI:1669979183
Name:TSEGAYE, CHAUNTA
Entity type:Individual
Prefix:MS
First Name:CHAUNTA
Middle Name:
Last Name:TSEGAYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 EASTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-2364
Mailing Address - Country:US
Mailing Address - Phone:248-249-6507
Mailing Address - Fax:
Practice Address - Street 1:71 CHARLES LN
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2926
Practice Address - Country:US
Practice Address - Phone:248-249-6507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
No174400000XOther Service ProvidersSpecialist
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information