Provider Demographics
NPI:1770163099
Name:TOROSSIAN, KRISTOPHER ANDREW (MD)
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:ANDREW
Last Name:TOROSSIAN
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 1:2132 KEYLON DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1329
Mailing Address - Country:US
Mailing Address - Phone:248-881-7602
Mailing Address - Fax:
Practice Address - Street 1:4201 ST. ANTOINE UHC-9C
Practice Address - Street 2:DETROIT MEDICAL CENTER GME OFFICE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-966-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-11
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4351048269207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program