Healthcare Provider Details

I. General information

NPI: 1699343046
Provider Name (Legal Business Name): MR. TAYLOR SCOTT CHRISTOPHEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2021
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 HENRY ST STE 120
NORTON SHORES MI
49441-4576
US

IV. Provider business mailing address

3570 HENRY ST STE 120
NORTON SHORES MI
49441-4576
US

V. Phone/Fax

Practice location:
  • Phone: 231-672-7000
  • Fax: 231-672-7053
Mailing address:
  • Phone: 231-672-7000
  • Fax: 231-728-5041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301517692
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: