Provider Demographics
NPI:1073595674
Name:ELSHOLZ, CHRISTINE AMBER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:AMBER
Last Name:ELSHOLZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:501 LAPEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6464
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:6297 DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:MI
Practice Address - Zip Code:48722-9635
Practice Address - Country:US
Practice Address - Phone:989-759-6460
Practice Address - Fax:989-759-6465
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2021-04-08
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Provider Licenses
StateLicense IDTaxonomies
MI4301063548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4761998Medicaid
MI1073595674Medicaid
150960OtherGREAT LAKES HEALTH PLAN
MI321OtherCARE SOURCE OF MICHIGAN
MI1017365OtherMCLAREN HEALTH PLAN OF MI
MIP00380702OtherRAILROAD MEDICARE
MI080G310660OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI0980802OtherHEALTHPLUS OF MICHIGAN
381908328OtherPPOM
4671988OtherMOLINA HEALTH CARE OF MI
MI7606126OtherAETNA
381908328OtherHCAP
381908328OtherHCAP
MIP00380702OtherRAILROAD MEDICARE