Healthcare Provider Details

I. General information

NPI: 1932495603
Provider Name (Legal Business Name): CHRISTOPHER M PARRES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

3555 W 13 MILE RD STE N120
ROYAL OAK MI
48073-6710
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-2585
  • Fax:
Mailing address:
  • Phone: 855-863-8761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number4301109575
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301109575
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: