DR. R CHASE THEBAULT, M.D.

Family Medicine

Active Individual
NPI: 1699920082

Practice Address

5716 MICHIGAN AVE
Detroit, MI 48210

Phone: (313) 554-1095

Specialties

Specialty Code Primary License
Family Medicine 207Q00000X Yes 4301104510 (MI)

Frequently Asked Questions

NPI 1699920082 is the National Provider Identifier for DR. R CHASE THEBAULT, M.D., a Family Medicine provider located in Detroit, MI. This NPI was enumerated on November 26, 2008.
DR. R CHASE THEBAULT, M.D. practices at 5716 MICHIGAN AVE, Detroit, MI 48210.

Quick Facts

NPI
1699920082
Type
Individual
Enumerated
Nov 26, 2008
Last Updated
May 18, 2022

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