Organization
CHRISTOPHER R DEANGELIS D.O
Active
Other names
Main Street Physicians P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
SARA M REIMAN (OFFICE MANAGER)
(734) 676-3373
Entity
Organization
Contact information
Practice address
25000 HALL RD, SUITE 1, WOODHAVEN, MI 48183-5112
(734) 676-3373
(734) 675-1678
Mailing address
25000 HALL RD, SUITE 1, WOODHAVEN, MI 48183-5112
(734) 676-3373
(734) 675-1678
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
CD013396
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110218318
RAILROAD MEDICARE
MI
01
—
1158206834
BCBS
MI
01
—
5390707
AETNA
MI
01
—
5820683
BCN
MI
01
—
C8111
M CARE
MI
01
—
P127746
CARE CHOICES
MI
Enumeration date
12/20/2007
Last updated
01/28/2019
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