Provider Demographics
NPI:1437112166
Name:MCTURK, CHRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:MCTURK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HAGGERTY RD
Mailing Address - Street 2:SUITE 2150
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2184
Mailing Address - Country:US
Mailing Address - Phone:248-926-6610
Mailing Address - Fax:248-926-6611
Practice Address - Street 1:2300 HAGGERTY RD
Practice Address - Street 2:SUITE 2150
Practice Address - City:WEST BLOOMFIEL;D
Practice Address - State:MI
Practice Address - Zip Code:48323-2184
Practice Address - Country:US
Practice Address - Phone:248-926-6610
Practice Address - Fax:248-926-6611
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F37550OtherBCN
MI4530954-10Medicaid
MID66118OtherHAP
MI700F37550OtherBCBSM
MI1962478743OtherCOMMERICAL
MI1962478743OtherCOMMERICAL
MID66118OtherHAP