Healthcare Provider Details

I. General information

NPI: 1285012260
Provider Name (Legal Business Name): CHRISTOPHER SOLIE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 WAYZATA BLVD STE 190
SAINT LOUIS PARK MN
55416-2627
US

IV. Provider business mailing address

111 HUNDERTMARK RD
CHASKA MN
55318-4551
US

V. Phone/Fax

Practice location:
  • Phone: 952-542-1840
  • Fax: 952-543-6524
Mailing address:
  • Phone: 952-442-2191
  • Fax: 319-384-6511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR10206
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number63900
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: