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R CHASE THEBAULT, M.D.
M.D.
Family Medicine Physician
NPI: 1699920082IndividualAccepts Medicare
Specialties, Licenses & Credentials
Family Medicine PhysicianPrimary
Family Medicine
Code: 207Q00000X
4301104510(MI)
CMS Specialties
PrimaryFAMILY PRACTICE
Education
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Class of 2006
Contact & Hours
- Address
- 5716 MICHIGAN AVE, COVENANT COMMUNITY CARE
DETROIT, MI 48210 - Phone
- (313) 554-1095
Quick Facts
- NPI
- 1699920082
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 1
- Locations
- 1
- Years in Practice
- 20
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