Provider Demographics
NPI:1184896169
Name:MCALPINE-TESFAI, CHRISTEN
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:MCALPINE-TESFAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 W GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-4516
Mailing Address - Country:US
Mailing Address - Phone:414-536-0236
Mailing Address - Fax:414-536-0260
Practice Address - Street 1:7720 W GOOD HOPE RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4516
Practice Address - Country:US
Practice Address - Phone:414-536-0236
Practice Address - Fax:414-536-0260
Is Sole Proprietor?:No
Enumeration Date:2008-03-30
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54111208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1184896169Medicaid