Christopher Canfield Green, M.D., PHD, FAAFS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301087789 Issued in MI

Practice address

50723 Harbour View Dr S
Med:for, Inc
New Baltimore, MI 48047-4347

Phone

(586) 876-5680

Fax

(586) 725-4865

NPI assigned

Sep 15, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414800000000",
    "number": "1013103811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50723 HARBOUR VIEW DR S",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480474347",
            "telephone_number": "586-876-5680",
            "fax_number": "586-725-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50723 HARBOUR VIEW DR S",
            "address_2": "MED:FOR, INC",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480474347",
            "telephone_number": "586-876-5680",
            "fax_number": "586-725-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "CANFIELD",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD, FAAFS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-15",
        "last_updated": "2014-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "MI",
            "license": "4301087789",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MI",
            "license": "4301087789",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NM",
            "license": "79-166",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "DC",
            "license": "MD12109",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301087789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in New Baltimore, MI
• Providers in New Baltimore, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.