Basic Information
| Provider Information | |||||||||
| NPI: | 1477907350 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOWNER | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | DANIELLE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BALL | ||||||||
| OtherFirstName: | CHRISTINA | ||||||||
| OtherMiddleName: | DANIELLE | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1000 E MAPLE ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488582833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896219473 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2853 HEALTH PKWY STE B | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488589375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897757641 | ||||||||
| FaxNumber: | 9897756472 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2016 | ||||||||
| LastUpdateDate: | 10/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 5101025281 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.