Provider Demographics
NPI:1194258624
Name:GEMAYEL, MICHAEL CHAOUKI
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHAOUKI
Last Name:GEMAYEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 COVINGTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3744
Mailing Address - Country:US
Mailing Address - Phone:248-648-9653
Mailing Address - Fax:
Practice Address - Street 1:1560 E MAPLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1135
Practice Address - Country:US
Practice Address - Phone:248-581-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA328103207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program