Provider Demographics
NPI:1477715530
Name:CHRISTIANSON, LEIF C
Entity Type:Individual
Prefix:DR
First Name:LEIF
Middle Name:C
Last Name:CHRISTIANSON
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:LEIF
Other - Middle Name:CONNORRAN
Other - Last Name:CHRISTIANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1001 E SUPERIOR ST
Mailing Address - Street 2:STE. L201
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2207
Mailing Address - Country:US
Mailing Address - Phone:218-249-3057
Mailing Address - Fax:218-249-3091
Practice Address - Street 1:1001 E SUPERIOR ST
Practice Address - Street 2:STE. L201
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2207
Practice Address - Country:US
Practice Address - Phone:218-249-3057
Practice Address - Fax:218-249-3091
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59873207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology