Provider Demographics
NPI:1689418758
Name:DARVIS, CHRISTOPHER ALAN
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:DARVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-2059
Mailing Address - Country:US
Mailing Address - Phone:734-299-6752
Mailing Address - Fax:
Practice Address - Street 1:4827 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-2059
Practice Address - Country:US
Practice Address - Phone:734-299-6752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant