Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2301011001 | MI |
N | 111NN0400X | Neurology | CH11652 | FL |
N | 111NN0400X | Neurology | CHIR009578 | GA |
N | 111NN0400X | Neurology | CR2344 | ME |
NPI | 1063876837 |
---|---|
Provider Name | Dr. Christopher Michael Sass |
First Address | Grand Rapids, MI 49546-3728 |
Second Address | Grand Rapids, MI 49546-3728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2016 |
Last Update Date | 03/06/2021 |