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General NPI Number Information
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NPI Number | 1487678686
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL FALLU D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6795 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48209-1551
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Country | US
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Telephone | 313-842-3388
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Fax | 313-842-3388
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Provider Business Mailing Address
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Address Line | 6795 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48209-1551
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Country | US
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Telephone | 313-842-3388
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Fax | 313-842-3388
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | CF001733
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License Number State | MI
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