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NPI Code Detail

MEDICARE: DR. MARK DEAN CHRISTENSEN MD

MEDICARE: DR. MARK DEAN CHRISTENSEN MD
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
1207Q00000XFamily Medicine PhysicianA115152CA
2207QS0010XSports Medicine (Family Medicine) PhysicianDR.0056009CO
3207Q00000XFamily Medicine Physician56009CO

General Provider Information

NPI Number : 1588944516
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK DEAN CHRISTENSEN MD
Provider Business Mailing Address
First Line : 1805 SHEA CENTER DR STE 301
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80129-2277
Country : US
Telephone Number : 303-814-0505
Fax Number : 303-814-6491
Provider Business Practice Location Address
First Line : 7280 LAGAE RD STE J
Second Line :
City : CASTLE PINES
State : CO
Zip : 80108-9454
Country : US
Telephone Number : 303-814-0505
Fax Number : 303-814-6491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2011
Last Update Date : 08/23/2023

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