Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301075471 | MI |
N | 111NI0900X | Internist | 4301075471 | MI |
Y | 207RH0002X | Hospice and Palliative Medicine | 4301075471 | MI |
NPI | 1366440463 |
---|---|
Provider Name | Dr. Christine Ann Crader |
First Address | Detroit, MI 48236-2167 |
Second Address | Detroit, MI 48236-2167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 21/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G34022 | (02) | MI |