Provider Demographics
NPI:1205144540
Name:CHIODO, ANGELA (CNM)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CHIODO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:CHIODO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1420 STEPHENSON HWY
Mailing Address - Street 2:SUITE 400-CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1189
Mailing Address - Country:US
Mailing Address - Phone:248-581-5970
Mailing Address - Fax:248-581-5640
Practice Address - Street 1:3750 WOODWARD AVE
Practice Address - Street 2:SUITE 200C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2007
Practice Address - Country:US
Practice Address - Phone:313-993-4645
Practice Address - Fax:313-993-4654
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P32150036Medicare PIN