Provider Demographics
NPI:1720177561
Name:CHERNIN, DENNIS KARL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:KARL
Last Name:CHERNIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 IVES LN
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4501
Mailing Address - Country:US
Mailing Address - Phone:734-662-2353
Mailing Address - Fax:734-662-2353
Practice Address - Street 1:2345 S HURON PKWY
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5124
Practice Address - Country:US
Practice Address - Phone:734-973-3030
Practice Address - Fax:734-973-3057
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010432762083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA75020Medicare UPIN