DR. CHATE WANSOM (NPI# 1780785931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780785931 |
| Entity Type | Individual |
| Full Name | DR. CHATE WANSOM |
| Credential | M.D. |
| Practice Address |
1492 N Monroe St Monroe MI 48162-4210 |
| Practice Telephone | 7342423060 |
| Practice Fax Number | 7342423062 |
| Mailing Telephone | 7342423060 |
| Mailing Fax Number | 7342423062 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 4301038906 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1395936 | 05 |
| Street Address |
1492 N MONROE ST |
| City | MONROE |
| State | MI |
| Zip Code | 48162-4210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417972308 | Saqib Razaq | Internal Medicine | 1492 N Monroe St, Monroe, MI 48162-4210 | 2006-07-13 |
| 1902061799 | Wansom Medical Center, P.C. | General Practice | 1492 N Monroe St, Monroe, MI 48162-4210 | 2008-07-22 |
| 1184649972 | Saqib Razaq, M.d.,p.c. | Internal Medicine | 1492 N Monroe St, Monroe, MI 48162-4210 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568016012 | Silke A Goudos | Nurse Practitioner | 730 N Macomb Street #200, Monroe, MI 48162 | 2019-08-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1740769702 | Carissa Pollock | Behavioral Analyst | 2086 S. Custer Rd., Monroe, MI 48162 | 2018-08-10 |
| 1710488440 | Stacy Michael Lucio | Nurse Practitioner | 901 N Macomb St Ste 109, Monroe, MI 48162 | 2018-02-27 |
| 1407239882 | Lisa Gilbert Peleman | Student in an Organized Health Care Education/Training Program | Promedica Monroe Regional Hospital Family Medicine Res, 650 Stewart Rd, Monroe, MI 48162 | 2015-07-03 |
| 1427430552 | Cheryl Fosgate | Counselor | 4350 N Monroe St, Monroe, MI 48162 | 2015-06-25 |
| 1538551460 | Convenient Mr PC | Dentist | 7500 N. Telegraph Rd., Monroe, MI 48162 | 2015-03-02 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1073872743 | Justin L Chamberlain | Surgery | 730 N Macomb St Ste 329, Monroe, MI 48162 | 2012-05-15 |
| 1639462674 | Toledo Clinic Incorporated | Durable Medical Equipment & Medical Supplies | 800 Stewart Road, Suite B, Monroe, MI 48162 | 2011-05-24 |
| Find all providers in zip 48162 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093950206 | J.r.b.supply Inc. | General Practice | 1285 North Telegraph Rd, #395, Monroe, MI 48162 | 2008-12-03 |
| 1023260486 | Integrated Health Services Incorporated | General Practice | 2101 Tower Dr, Monroe, LA 71201-5045 | 2008-10-16 |
| 1629251822 | Steven R Taraszka PC | General Practice | 924 West Spring St, Monroe, GA 30655 | 2007-12-11 |
| 1366512428 | Benjamin M Stage | General Practice | 1136 Oliver Rd, Monroe, LA 71201-5714 | 2006-11-08 |
| 1063411056 | David L. Barnes | General Practice | 3400 Medical Park Dr, Suite C, Monroe, LA 71203-2388 | 2005-07-20 |
| 1952928467 | Edwin David | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-30 |
| 1366067779 | Megan Wolbers | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-11 |
| 1598380909 | Himat Singh Gill | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-11 |
| 1770107450 | Amy Tesolin-gee | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-05-29 |
| 1790305621 | Matthew Thomas Hutcherson | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-04-21 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.