Provider Demographics
NPI:1679382709
Name:CORWIN, CHADD STUART
Entity type:Individual
Prefix:
First Name:CHADD
Middle Name:STUART
Last Name:CORWIN
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 1:43055 STRAND DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-2741
Mailing Address - Country:US
Mailing Address - Phone:313-682-6277
Mailing Address - Fax:
Practice Address - Street 1:43055 STRAND DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-2741
Practice Address - Country:US
Practice Address - Phone:313-682-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator