1942486808 NPI number — CHRISTOPHER J ORAVITZ MD

Table of content: (NPI 1942486808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942486808 NPI number — CHRISTOPHER J ORAVITZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTOPHER J ORAVITZ MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942486808
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4449 FASHION SQUARE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48603-5217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-790-0007
Provider Business Mailing Address Fax Number:
989-790-7547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4364 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48603-4030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-791-9500
Provider Business Practice Location Address Fax Number:
989-791-4690
Provider Enumeration Date:
01/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ORAVATIZ
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
989-791-9500

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  4301060262 , 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)

  • Identifier: 4201400 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com