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General NPI Number Information
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NPI Number | 1124075684
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Entity Type | Individual
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Provider Name | CHRISTINA L. CAMPBELL D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6310 SASHABAW RD STE A CHRISTINA CAMPBELL, DO, PLLC
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City | CLARKSTON
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State | MI
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Zip | 48346-2270
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Country | US
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Telephone | 248-425-8352
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Fax |
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Provider Business Mailing Address
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Address Line | 4572 OAKHURST RIDGE RD
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City | CLARKSTON
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State | MI
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Zip | 48348-5071
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Country | US
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Telephone | 248-425-8352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101014451
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License Number State | MI
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