MEDICARE: FRONT RANGE RETINA, P.C.

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	207WX0107X	Retina Specialist (Ophthalmology) Physician

General Provider Information

NPI Number	:	1831780980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONT RANGE RETINA, P.C.

Provider Business Mailing Address
First Line	:	3740 DACORO LN STE 145
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-2504
Country	:	US
Telephone Number	:	720-828-3937
Fax Number	:	720-405-4355

Provider Business Practice Location Address
First Line	:	3740 DACORO LN STE 145
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-2504
Country	:	US
Telephone Number	:	720-828-3937
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	STEVEN M CHRISTIANSEN
Credential	:	MD
Telephone Number	:	720-828-3937

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	03/04/2023

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Directions to “FRONT RANGE RETINA, P.C. ” Practice Location

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