Provider Demographics
NPI:1104897107
Name:CHARTIER, MICHELLE (DO)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CHARTIER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25620 GIBRALTAR RD
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:MI
Mailing Address - Zip Code:48134-1243
Mailing Address - Country:US
Mailing Address - Phone:734-789-9355
Mailing Address - Fax:734-789-1520
Practice Address - Street 1:25620 GIBRALTAR RD
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134-1243
Practice Address - Country:US
Practice Address - Phone:734-789-9355
Practice Address - Fax:734-789-1520
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine