Catherine Marie Chimo, PA
Individual provider Active NPI Physician Assistant · Ithaca, MI
NPI 1508896523 · NPPES record last updated Mar 3, 2011
Key facts
- NPI
- 1508896523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601001489 (MI)
- Practice address
- 820 N Pine River St
Ithaca, MI 48847-1118 - Phone
- (989) 875-3722
- Fax
- (989) 875-8903
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001489 | MI | Yes |
Addresses
Primary practice location
820 N Pine River St
Ithaca, MI 48847-1118
Mailing address
PO Box 994
Alma, MI 48801-0994
Phone (989) 466-7188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0852915050 | Other | MI | BCBSM |
Other providers in Ithaca, MI
- Braden Ball
- Martha A Bamfield
- Joseph Alan Baxter
- Amy Bray
- Alex Sean Catlin
- Daily Living Homecare, Inc.
- Darren M Riopelle DDS
- Ryan Richard Dietlein
- Donald G Prouty
- Donald G Prouty
All providers in Ithaca, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.