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NPI Code Detail

MEDICARE: CHRISTOPHER MILBACK M.D.

MEDICARE: CHRISTOPHER MILBACK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4301076952MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080F370780OTHERMIBCBSM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700852720
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER MILBACK M.D.
Provider Business Mailing Address
First Line : 44250 DEQUINDRE RD
Second Line : FAMILY MEDICINE
City : STERLING HEIGHTS
State : MI
Zip : 48314-1002
Country : US
Telephone Number : 248-964-0400
Fax Number : 248-964-0401
Provider Business Practice Location Address
First Line : 44250 DEQUINDRE RD
Second Line : FAMILY MEDICINE
City : STERLING HEIGHTS
State : MI
Zip : 48314-1002
Country : US
Telephone Number : 248-964-0400
Fax Number : 248-964-0401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 05/02/2013

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