Provider Demographics
NPI:1619049640
Name:CRISTOF, NELU (MD)
Entity Type:Individual
Prefix:
First Name:NELU
Middle Name:
Last Name:CRISTOF
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 1:550 OSBORN BLVD
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1899
Mailing Address - Country:US
Mailing Address - Phone:906-635-3002
Mailing Address - Fax:
Practice Address - Street 1:550 OSBORN BLVD
Practice Address - Street 2:SUITE 1006
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1899
Practice Address - Country:US
Practice Address - Phone:906-635-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037635207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3311416Medicaid
MI3311416Medicaid
MIA76002Medicare Oscar/Certification
MIA76002Medicare ID - Type Unspecified