Healthcare Provider Details

I. General information

NPI: 1518474154
Provider Name (Legal Business Name): CAMILLE ANDREA CHRISTIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34290 FORD RD
WESTLAND MI
48185-3051
US

IV. Provider business mailing address

34290 FORD RD
WESTLAND MI
48185-3051
US

V. Phone/Fax

Practice location:
  • Phone: 888-813-8326
  • Fax:
Mailing address:
  • Phone: 734-412-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: