Healthcare Provider Details

I. General information

NPI: 1518906080
Provider Name (Legal Business Name): CHRISTOPHER JAMES NOAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 N M 37 HWY STE M
MIDDLEVILLE MI
49333-8167
US

IV. Provider business mailing address

4525 N M 37 HWY STE M
MIDDLEVILLE MI
49333-8167
US

V. Phone/Fax

Practice location:
  • Phone: 269-795-4434
  • Fax: 269-795-4271
Mailing address:
  • Phone: 269-795-4434
  • Fax: 269-795-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCN58114
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: