Provider Demographics
NPI:1316082050
Name:ORAVITZ, CHRISTOPHER J (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:ORAVITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E M 55
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9362
Mailing Address - Country:US
Mailing Address - Phone:989-362-2540
Mailing Address - Fax:989-362-7290
Practice Address - Street 1:25 E M 55
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9362
Practice Address - Country:US
Practice Address - Phone:989-362-2540
Practice Address - Fax:989-362-7290
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICO060262207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI160049787OtherRAILROAD MEDICARE #
MI14493OtherGREAT LAKES HEALTH PLAN #
MI0000000070OtherCAPE HEALTH PLAN #
MI1006413OtherMCLAREN HEALTH PLAN #
MIC39880OtherMCARE #
MI104201400Medicaid
MI383516078OtherTAX ID #
MI1607367690OtherBCBS #
MA95C00857OtherHEALTHPLUS #
MI17917OtherCOMMUNITY CHOICE #
MI383516078OtherTAX ID #
MI104201400Medicaid