Provider Demographics
NPI:1336167063
Name:CHRISTENSEN, STEFFEN P (MD)
Entity Type:Individual
Prefix:
First Name:STEFFEN
Middle Name:P
Last Name:CHRISTENSEN
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 1:1111 HARWOOD DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4603
Mailing Address - Country:US
Mailing Address - Phone:701-280-4700
Mailing Address - Fax:701-280-4750
Practice Address - Street 1:1111 HARWOOD DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4603
Practice Address - Country:US
Practice Address - Phone:701-280-4700
Practice Address - Fax:701-280-4750
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23837207V00000X
ND3893207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12426Medicaid
NDN1475Medicare PIN
MN160002611Medicare PIN
D25798Medicare UPIN
MN160003455Medicare PIN
ND12426Medicaid