Chisum, Michael Stephen

Chisum, Michael Stephen is an individual health care provider with primary practice located at 751 Ne Blakely Dr Ste 4020 , Issaquah WA 98029-6201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Chisum, Michael Stephen can be contacted via phone (425) 313-7124.

Contact Information

Primary practice address
751 Ne Blakely Dr Ste 4020 Issaquah WA 98029-6201
Phone: (425) 313-7124
Fax: (425) 313-7072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD61170311 Washington

Profile Details

NPI number 1265963771
LBN Legal business name Chisum, Michael Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2017
Last updated Dec 1st, 2022 - about 4 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 1265963771 NPPES
Washington MEDICAID 2084042

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