MEDICARE: DR. CHRISTINE ANN NEFCY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	70443801205	UT
2	208000000X	Pediatrics Physician	4301089636	MI

General Provider Information

NPI Number	:	1043295967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE ANN NEFCY MD

Provider Business Mailing Address
First Line	:	2100 RAYBROOK ST SE STE 100B
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-5782
Country	:	US
Telephone Number	:	616-320-0096
Fax Number	:	616-320-0097

Provider Business Practice Location Address
First Line	:	1023 BUSINESS PARK DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-8372
Country	:	US
Telephone Number	:	616-320-0069
Fax Number	:	616-320-0097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	12/03/2025

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