Provider Demographics
NPI:1851562151
Name:DAVID W CHRISTENSEN
Entity Type:Organization
Organization Name:DAVID W CHRISTENSEN
Other - Org Name:BIRDSBORO FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-582-1561
Mailing Address - Street 1:100 S SPRUCE ST
Mailing Address - Street 2:P.O. BOX 65
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-2344
Mailing Address - Country:US
Mailing Address - Phone:610-582-1561
Mailing Address - Fax:610-582-3385
Practice Address - Street 1:100 S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-2344
Practice Address - Country:US
Practice Address - Phone:610-582-1561
Practice Address - Fax:610-582-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087084Medicare PIN