Healthcare Provider Details

I. General information

NPI: 1952995946
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL CALABRESE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 02/13/2024
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W MAPLE RD
BIRMINGHAM MI
48009
US

IV. Provider business mailing address

43422 W. OAKS DRIVE STE. 191
NOVI MI
48377
US

V. Phone/Fax

Practice location:
  • Phone: 866-766-3783
  • Fax: 248-254-6524
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: