Healthcare Provider Details

I. General information

NPI: 1083529911
Provider Name (Legal Business Name): CHRISTOPHER YONGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 N WAYNE RD
WESTLAND MI
48185-1137
US

IV. Provider business mailing address

43000 DANIEL DR
VAN BUREN TOWNSHIP MI
48111-5412
US

V. Phone/Fax

Practice location:
  • Phone: 734-425-0636
  • Fax:
Mailing address:
  • Phone: 734-645-1138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: