Provider Demographics
NPI:1518906080
Name:NOAH, CHRISTOPHER JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:NOAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4525 N M 37 HWY
Mailing Address - Street 2:STE M
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-8167
Mailing Address - Country:US
Mailing Address - Phone:269-795-4434
Mailing Address - Fax:269-795-4271
Practice Address - Street 1:4525 N M 37 HWY
Practice Address - Street 2:STE M
Practice Address - City:MIDDLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:49333-8167
Practice Address - Country:US
Practice Address - Phone:269-795-4434
Practice Address - Fax:269-795-4271
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MICN58114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900002829OtherPRIORITY HEALTH
MI0080023OtherBC/BS OF MICHIGAN
MI15994OtherHEALTH PLAN OF MICHIGAN
MI4260367Medicaid
MI4260367Medicaid