Chaney, Gloria

Chaney, Gloria is an individual health care provider with primary practice located at 12871 E Jefferson Ave , Detroit MI 48215-2754. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Chaney, Gloria can be contacted via phone (313) 821-3900.

Contact Information

Primary practice address
12871 E Jefferson Ave Detroit MI 48215-2754
Phone: (313) 821-3900
Fax: (313) 821-1511
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101009530 Michigan

Profile Details

NPI number 1548252240
LBN Legal business name Chaney, Gloria
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Jan 19th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548252240 NPPES
Michigan MEDICAID 3221696-11

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