Theodore R Densley
LOLITA CHANDLER


Address: 15101 W Mcnichols, Detroit, MI 48235-3716
Phone: 3133077273

Theodore R Densley (NPI# 1891701884, PAC ID# 9537140520) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ADDICTION MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1891701884
PAC ID by PECOS 9537140520
Professional Enrollment ID I20040526000506
Full Name Theodore R Densley
Organization Legal Name LOLITA CHANDLER
Address 15101 W Mcnichols
Detroit
MI 48235-3716
Phone Number 3133077273
Gender M
Credential MD
Medical School PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year 1974
Primary Specialty ADDICTION MEDICINE
Group Practice PAC ID 2163662024
Number of Group Practice Members 2
Accepts Medicare Assignment Y

Other Locations

Address Phone Organization
15101 W Mcnichols, Detroit, MI 48235-3716 3133077273 LOLITA CHANDLER

Organization Information

Organization Legal Name LOLITA CHANDLER
Physicians 1

Office Location

Street Address 15101 W MCNICHOLS
City DETROIT
State MI
Zip 48235-3716

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Competitor

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City DETROIT
Zip Code 48235
Specialty ADDICTION MEDICINE
City + Specialty DETROIT + ADDICTION MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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