Healthcare Provider Details

I. General information

NPI: 1992094932
Provider Name (Legal Business Name): DAVID ALAN CHRISTIANSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2011
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 EVERGREEN DR NE
GRAND RAPIDS MI
49525-9493
US

IV. Provider business mailing address

3333 EVERGREEN DR NE
GRAND RAPIDS MI
49525-9493
US

V. Phone/Fax

Practice location:
  • Phone: 616-364-4200
  • Fax: 616-364-7347
Mailing address:
  • Phone: 616-364-4200
  • Fax: 616-284-3133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberCDR.0005732
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01097737A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number4301108986
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC4665
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301108986
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberW1567
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: