Provider Demographics
NPI:1982775029
Name:MARKUS, CHRISTINE KAY (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KAY
Last Name:MARKUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 CURVE CREST BLVD W STE 100
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6062
Mailing Address - Country:US
Mailing Address - Phone:651-275-0500
Mailing Address - Fax:651-430-3827
Practice Address - Street 1:1950 CURVE CREST BLVD W STE 100
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6062
Practice Address - Country:US
Practice Address - Phone:651-275-0500
Practice Address - Fax:651-430-3827
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34639207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF13643Medicare UPIN
MN070000521Medicare ID - Type UnspecifiedINDIVIDUAL