Healthcare Provider Details

I. General information

NPI: 1689962342
Provider Name (Legal Business Name): CHRISTOPHER MINNOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 KIRTS BLVD STE 160
TROY MI
48084-4852
US

IV. Provider business mailing address

26211 CENTRAL PARK BLVD STE 201
SOUTHFIELD MI
48076-4158
US

V. Phone/Fax

Practice location:
  • Phone: 248-244-9426
  • Fax: 844-607-0511
Mailing address:
  • Phone: 833-667-3627
  • Fax: 833-972-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301110881
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number4301110881
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: