Provider Demographics
NPI:1871066423
Name:CHAMBERS, EMANUEL SHAUNTTEE
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:SHAUNTTEE
Last Name:CHAMBERS
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 1:23844 MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3495
Mailing Address - Country:US
Mailing Address - Phone:313-930-0309
Mailing Address - Fax:
Practice Address - Street 1:23844 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3495
Practice Address - Country:US
Practice Address - Phone:313-930-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information