Healthcare Provider Details

I. General information

NPI: 1306546270
Provider Name (Legal Business Name): ANDRA CRISTIU PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44245 FORD RD STE 101
CANTON MI
48187-3163
US

IV. Provider business mailing address

46418 BARTLETT DR
CANTON MI
48187-1517
US

V. Phone/Fax

Practice location:
  • Phone: 248-977-7247
  • Fax:
Mailing address:
  • Phone: 248-884-3546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601011584
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: