Healthcare Provider Details

I. General information

NPI: 1386935575
Provider Name (Legal Business Name): CHRISTINE POISSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44428 WOODWARD AVE STE 104
PONTIAC MI
48341-5009
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR PO BOX 0446 LOBBY J
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 248-858-6272
  • Fax: 248-883-0059
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301108078
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT199978
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: