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NPI Code Detail

MEDICARE: CARL CHRISTENSEN MD PLLC

MEDICARE: CARL CHRISTENSEN MD PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0401XAddiction Medicine (Family Medicine) Physician4301048048MI

General Provider Information

NPI Number : 1164830048
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARL CHRISTENSEN MD PLLC
Provider Business Mailing Address
First Line : 2370 LEFORGE RD
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-9638
Country : US
Telephone Number : 734-448-0226
Fax Number : 313-447-2244
Provider Business Practice Location Address
First Line : 2370 LEFORGE RD
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-9638
Country : US
Telephone Number : 734-448-0226
Fax Number : 313-447-2244
Authorized Official
Title or Position : SOLE MEMBER
Name : DR. CARL WOODROW CHRISTENSEN
Credential : MD
Telephone Number : 734-218-5317
Provider Enumeration Date : 07/23/2014
Last Update Date : 07/23/2014

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Directions to “CARL CHRISTENSEN MD PLLC ” Practice Location

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