Provider Demographics
NPI:1679953996
Name:ALCHAMMAS, JORGE
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:ALCHAMMAS
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 1:48709 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-2562
Mailing Address - Country:US
Mailing Address - Phone:586-822-8170
Mailing Address - Fax:
Practice Address - Street 1:48709 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-2562
Practice Address - Country:US
Practice Address - Phone:586-383-4702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107571207R00000X
WAMD610367382085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine