Provider Demographics
NPI:1609087618
Name:INTERNAL MEDICINE CONSULTANTS, PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-336-9052
Mailing Address - Street 1:7251 W 20TH ST
Mailing Address - Street 2:UNIT K
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4625
Mailing Address - Country:US
Mailing Address - Phone:970-336-9052
Mailing Address - Fax:
Practice Address - Street 1:7251 W 20TH ST
Practice Address - Street 2:UNIT K
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4625
Practice Address - Country:US
Practice Address - Phone:970-336-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COINS4208OtherBCBS
CD2881OtherRAILROAD MEDICARE
CO04007969Medicaid
COINS4208OtherBCBS