Bothuell, Chantale Esther

Bothuell, Chantale Esther is an sole proprietor health care provider with primary practice located at 2424 Fordham St , Keego Harbor MI 48320-1412. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Bothuell, Chantale Esther can be contacted via phone (313) 384-7300.

Contact Information

Primary practice address
2424 Fordham St Keego Harbor MI 48320-1412
Fax: (248) 747-4014
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901002140 Michigan

Profile Details

NPI number 1457566341
LBN Legal business name Bothuell, Chantale Esther
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 14th, 2007
Last updated Mar 9th, 2017 - about 7 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 1457566341 NPPES
Michigan MEDICAID 2265017

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