Provider Demographics
NPI:1285622050
Name:CUMMINGS, CHRISTOPHER BRIAN (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LAPEER
Mailing Address - Street 2:HEALTH DELIVERY INC
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607
Mailing Address - Country:US
Mailing Address - Phone:989-759-6400
Mailing Address - Fax:989-759-6423
Practice Address - Street 1:1522 JANES ST.
Practice Address - Street 2:JANES ST. COMMUNITY HEALTH CENTER
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601
Practice Address - Country:US
Practice Address - Phone:989-755-0316
Practice Address - Fax:989-755-0956
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI561003259363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
139494OtherGREAT LAKES HEALTH PLAN
MI198OtherCOMMUNITY CHOICE
MI3500576OtherMOLINA HEALTH CARE
970010555OtherRAILROAD MEDICARE
1010142OtherMCLAREN HEALTH PLAN
1010142OtherHEALTH ADVANTAGE
1010142OtherHEALTH ADVANTAGE
M93030P03Medicare ID - Type Unspecified