Healthcare Provider Details

I. General information

NPI: 1740464866
Provider Name (Legal Business Name): CRYSTAL JOYCE ENYIH CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRYSTAL JOYCE POPE CPM

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38215 W 10 MILE RD STE 6
FARMINGTON HILLS MI
48335-2866
US

IV. Provider business mailing address

38215 W 10 MILE RD STE 6
FARMINGTON HILLS MI
48335-2866
US

V. Phone/Fax

Practice location:
  • Phone: 313-351-5331
  • Fax:
Mailing address:
  • Phone: 313-351-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number06090012
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: