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General NPI Number Information
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NPI Number | 1811171234
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER R DEANGELIS D.O
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 25000 HALL RD SUITE 1
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City | WOODHAVEN
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State | MI
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Zip | 48183-5112
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Country | US
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Telephone | 734-676-3373
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Fax | 734-675-1678
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Provider Business Mailing Address
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Address Line | 25000 HALL RD SUITE 1
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City | WOODHAVEN
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State | MI
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Zip | 48183-5112
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Country | US
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Telephone | 734-676-3373
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Fax | 734-675-1678
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SARA M REIMAN
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Credential |
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Telephone | 734-676-3373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | CD013396
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License Number State | MI
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