Provider Demographics
NPI:1144209305
Name:CHRISTENSEN, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:CHRISTENSEN
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:PO BOX 2467
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81302-2467
Mailing Address - Country:US
Mailing Address - Phone:970-385-4022
Mailing Address - Fax:970-385-4337
Practice Address - Street 1:2 BURNETT CT # 100
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-3647
Practice Address - Country:US
Practice Address - Phone:970-385-4022
Practice Address - Fax:970-385-4337
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COT0861207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01336049Medicaid
CO01336049Medicaid
COD3048Medicare PIN