Healthcare Provider Details

I. General information

NPI: 1679154587
Provider Name (Legal Business Name): CHRISTOPHER JOHN RICHARDSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W 66TH ST STE 150
EDINA MN
55435-2109
US

IV. Provider business mailing address

4225 GOLDEN VALLEY RD
GOLDEN VALLEY MN
55422-4215
US

V. Phone/Fax

Practice location:
  • Phone: 952-920-7200
  • Fax: 763-287-2303
Mailing address:
  • Phone: 952-588-0661
  • Fax: 763-287-2303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number81877
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: