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General NPI Number Information
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NPI Number | 1851584973
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Entity Type | Organization
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Legal Business Name | STEVEN D CHRISTESEN MD PA
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 3440 TAMIAMI TRL STE 2
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8134
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Country | US
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Telephone | 941-624-3600
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Fax | 941-624-0700
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Provider Business Mailing Address
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Address Line | PO BOX 495839
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-5839
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Country | US
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Telephone | 941-624-3600
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Fax | 941-624-0700
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STEVEN D CHRISTESEN
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Credential | MD PA
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Telephone | 941-624-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME66791
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License Number State | FL
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