Provider Demographics
NPI:1356998397
Name:DAVID CRISS MD PC
Entity type:Organization
Organization Name:DAVID CRISS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-808-4578
Mailing Address - Street 1:23077 GREENFIELD RD STE 280
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3716
Mailing Address - Country:US
Mailing Address - Phone:248-557-3337
Mailing Address - Fax:248-557-3339
Practice Address - Street 1:23077 GREENFIELD RD STE 280
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3716
Practice Address - Country:US
Practice Address - Phone:248-557-3337
Practice Address - Fax:248-557-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty