Basic Information
Provider Information
NPI: 1043873870
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REJI
FirstName: CHRISTINA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17177 N LAUREL PARK DR STE 439
Address2:  
City: LIVONIA
State: MI
PostalCode: 481523938
CountryCode: US
TelephoneNumber: 7344620340
FaxNumber: 7344620344
Practice Location
Address1: 6071 W OUTER DR
Address2:  
City: DETROIT
State: MI
PostalCode: 482352624
CountryCode: US
TelephoneNumber: 3139663300
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2019
LastUpdateDate: 06/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301506009MIY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home