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NPI Code Detail

MEDICARE: TORI FAE CHRISTIAANSEN MD

MEDICARE: TORI FAE CHRISTIAANSEN MD
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
1207Q00000XFamily Medicine Physician42626MN

General Provider Information

NPI Number : 1831138205
Entity Type Code : Individual
Provider Name (Legal Business Name) : TORI FAE CHRISTIAANSEN MD
Provider Business Mailing Address
First Line : 290 MAIN ST NW
Second Line :
City : ELK RIVER
State : MN
Zip : 55330-1270
Country : US
Telephone Number : 763-241-5800
Fax Number :
Provider Business Practice Location Address
First Line : 290 MAIN ST NW
Second Line :
City : ELK RIVER
State : MN
Zip : 55330-1270
Country : US
Telephone Number : 763-241-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 05/19/2008

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Directions to “ TORI FAE CHRISTIAANSEN MD” Practice Location

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