MEDICARE: KHRISTIAN DANTE FERMIL

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
1	363L00000X	Nurse Practitioner	4704294458	MI

General Provider Information

NPI Number	:	1942143672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHRISTIAN DANTE FERMIL

Provider Business Mailing Address
First Line	:	6831 SPRUCE DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3059
Country	:	US
Telephone Number	:	586-604-5208
Fax Number	:

Provider Business Practice Location Address
First Line	:	6831 SPRUCE DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3059
Country	:	US
Telephone Number	:	586-604-5208
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ KHRISTIAN DANTE FERMIL ” Practice Location

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