Basic Information
Provider Information
NPI: 1790986644
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GANS
FirstName: CHRISTOPHER
MiddleName: PAUL
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481081633
CountryCode: US
TelephoneNumber: 7346475299
FaxNumber:  
Practice Location
Address1: 24 FRANK LLOYD WRIGHT DR
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481059484
CountryCode: US
TelephoneNumber: 8882871082
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/29/2007
LastUpdateDate: 10/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X036119438ILN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000X4301507515MIY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207R00000X036119438ILN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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