Healthcare Provider Details

I. General information

NPI: 1821418419
Provider Name (Legal Business Name): CHRISTINA LOUISE SANTIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDREN'S HOSPITAL OF MI/ SPEC CTR 3950 BEAUBIEN GARDEN LEVEL
DETROIT MI
48201
US

IV. Provider business mailing address

CHILDREN'S HOSPITAL OF MI/ SPEC CTR 3950 BEAUBIEN GARDEN LEVEL
DETROIT MI
48201-3026
US

V. Phone/Fax

Practice location:
  • Phone: 313-832-8871
  • Fax: 313-966-7445
Mailing address:
  • Phone: 313-832-8871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101024032
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number5101024032
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: