Basic Information
| Provider Information | |||||||||
| NPI: | 1316520539 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SLEEPER | ||||||||
| FirstName: | CHRISTIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 E MEDICAL CENTER DRIVE | ||||||||
| Address2: | UH B1 502, SPC5030 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095030 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 1500 E MEDICAL CENTER DRIVE | ||||||||
| Address2: | UH B1 502, SPC5030 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346154924 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2021 | ||||||||
| LastUpdateDate: | 05/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 4351047825 | MI | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.