Healthcare Provider Details

I. General information

NPI: 1760359830
Provider Name (Legal Business Name): CHRISTOPHER SAMUEL SIMPSON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 W BRISTOL RD
FLINT MI
48507-5516
US

IV. Provider business mailing address

17149 WARWICK ST
DETROIT MI
48219-3513
US

V. Phone/Fax

Practice location:
  • Phone: 810-496-5500
  • Fax:
Mailing address:
  • Phone: 313-717-4109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: