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General NPI Number Information
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NPI Number | 1083674337
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Entity Type | Individual
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Provider Name | CHARLES E. CHRISTIANSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 501 COLUMBIA RD DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
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City | GRAND FORKS
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State | ND
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Zip | 58202-9037
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Country | US
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Telephone | 701-777-3240
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Fax | 701-777-4849
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Provider Business Mailing Address
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Address Line | 501 N COLUMBIA RD DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
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City | GRAND FORKS
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State | ND
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Zip | 58202-9037
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Country | US
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Telephone | 701-777-3240
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Fax | 701-777-4849
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9006
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License Number State | ND
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