Healthcare Provider Details

I. General information

NPI: 1679264212
Provider Name (Legal Business Name): CHRISTIAN FRITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 E 12 MILE RD
WARREN MI
48093-3472
US

IV. Provider business mailing address

27351 DEQUINDRE RD
MADISON HEIGHTS MI
48071-3487
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-5059
  • Fax:
Mailing address:
  • Phone: 248-967-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number441234153976
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: