Individual
CHRISTOPHER R DEANGELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
25000 HALL RD, STE 1, TRENTON, MI 48183-5112
(734) 676-3373
(734) 676-2014
Mailing address
25000 HALL RD, STE 1, TRENTON, MI 48183-5112
(734) 676-3373
(734) 676-2014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
CD013396
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110218319
RAILROAD
—
01
—
1158206834
BCBS
—
01
—
1172589003
CIGNA
—
01
—
38-3510876
TAX ID#
—
01
—
5390707
AETNA
—
01
—
C8111
M-CARE
—
01
—
CD013396
STATE LIC#
—
01
—
P109110
BCN
—
01
—
P127746
CARE CHOICES
—
Enumeration date
07/14/2005
Last updated
03/07/2023
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