Provider Demographics
NPI:1861070765
Name:AMDAHL, CHRISTOFFER ALTON DIMLA (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOFFER
Middle Name:ALTON DIMLA
Last Name:AMDAHL
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 1:15 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5736
Mailing Address - Country:US
Mailing Address - Phone:207-626-1894
Mailing Address - Fax:
Practice Address - Street 1:2727 LEO HARRIS PKWY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8835
Practice Address - Country:US
Practice Address - Phone:541-346-2257
Practice Address - Fax:855-850-1265
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD27991207Q00000X
390200000X
ORMD225485207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program