Provider Demographics
NPI:1710982533
Name:REYNOLDS, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:REYNOLDS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5301 E HURON RIVER DR
Mailing Address - Street 2:SUITE C139
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1051
Mailing Address - Country:US
Mailing Address - Phone:734-712-1000
Mailing Address - Fax:734-712-1012
Practice Address - Street 1:5301 E HURON RIVER DR
Practice Address - Street 2:SUITE C139
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-712-1000
Practice Address - Fax:734-712-1012
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2011-07-14
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Provider Licenses
StateLicense IDTaxonomies
MI4301065161207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H16099014Medicare PIN