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DR. MARK DAVID CHRISTENSON MD

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1699883447

Individual Registrant:
DR. MARK DAVID CHRISTENSON MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
910 NW 16TH ST STE 102  FRUITLAND, ID 83619-2265 US
Tel: 208-452-8015  Fax: 208-452-8055

Contact information for business:
3340 EAST GOLDSTONE WAY  MERIDIAN, ID 83642-1026 US
Tel: 208-452-8015  Fax: 208-452-8055

Registration Information:
NPI: 1699883447
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
IDM11489
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
ORMD156651

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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