Provider Demographics
NPI:1881232635
Name:CUMMINGS, CHRISTOPHER (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 GENESEE POINT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8737
Mailing Address - Country:US
Mailing Address - Phone:801-473-4771
Mailing Address - Fax:
Practice Address - Street 1:343 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1037
Practice Address - Country:US
Practice Address - Phone:248-717-0074
Practice Address - Fax:248-717-0150
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV363AM0700X
NVPA2241363AS0400X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPA2241OtherNV LICENSE