Provider Demographics
NPI:1336588029
Name:VAHABZADEH, CHRISTIE MARIE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:MARIE
Last Name:VAHABZADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:MARIE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2761 PLUM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48363-2150
Mailing Address - Country:US
Mailing Address - Phone:248-872-3126
Mailing Address - Fax:
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-872-3126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301102797207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology