Organization
COUNTRY DOCTOR FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISITNE SYPITKOWSKI DO (OWNER)
(248) 693-4500
Entity
Organization
Contact information
Practice address
720 N LAPEER RD, STE 101, LAKE ORION, MI 48362-4011
(248) 693-4500
(248) 693-8170
Mailing address
720 N LAPEER RD, STE 101, LAKE ORION, MI 48362-4011
(248) 693-4500
(248) 693-8170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010326
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0156300595
BCBSM
MI
Enumeration date
03/22/2007
Last updated
08/22/2020
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