Provider Demographics
NPI:1649487984
Name:REMISHOFSKY, CHRISTOPHER JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:REMISHOFSKY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39242 DEQUINDRE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-1764
Mailing Address - Country:US
Mailing Address - Phone:586-979-1750
Mailing Address - Fax:
Practice Address - Street 1:39242 DEQUINDRE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-1764
Practice Address - Country:US
Practice Address - Phone:586-979-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084290207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP47710003OtherMEDICARE PTAN