Healthcare Provider Details

I. General information

NPI: 1316563844
Provider Name (Legal Business Name): DAVID CHRISTOPHER FIKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2020
Last Update Date: 03/22/2025
Certification Date: 03/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 UNIVERSITY AVE
FLINT MI
48504-6208
US

IV. Provider business mailing address

307 S PORTER ST
SAGINAW MI
48602-2325
US

V. Phone/Fax

Practice location:
  • Phone: 810-238-0475
  • Fax: 810-238-9270
Mailing address:
  • Phone: 859-420-9481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801117858
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: