MEDICARE: DR. MARC DUANE CHRISTENSEN MD, PHD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	73109	AZ
2	207T00000X	Neurological Surgery Physician	284220	MA

General Provider Information

NPI Number	:	1396747218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC DUANE CHRISTENSEN MD, PHD, PA

Provider Business Mailing Address
First Line	:	72 LAKE HAVASU AVE S STE 102
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-0857
Country	:	US
Telephone Number	:	928-453-2211
Fax Number	:	928-453-2213

Provider Business Practice Location Address
First Line	:	72 LAKE HAVASU AVE S STE 102
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-0857
Country	:	US
Telephone Number	:	928-453-2211
Fax Number	:	928-453-2213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/08/2025

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