1801587266 NPI number — DR. LILIA POPOVA CHRISTNER MD, MPH

Table of content: DR. LILIA POPOVA CHRISTNER MD, MPH (NPI 1801587266)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801587266 NPI number — DR. LILIA POPOVA CHRISTNER MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTNER
Provider First Name:
LILIA
Provider Middle Name:
POPOVA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
POPOVA
Provider Other First Name:
LILIA
Provider Other Middle Name:
TCHAVDAROVA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801587266
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1522 SIMPSON DR
Provider Second Line Business Mailing Address:
MPB D3230
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-647-1774
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4260 PLYMOUTH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48109-2700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-539-5080
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , with the licence number:  4351050558 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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