Provider Demographics
NPI:1154532448
Name:AFMAN, CHAD (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:AFMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC 845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4069 LAKE DR SE
Practice Address - Street 2:SUITE 315
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8816
Practice Address - Country:US
Practice Address - Phone:616-267-7758
Practice Address - Fax:616-267-7290
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2021-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301091223207Y00000X, 207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M74460651Medicare PIN