Individual
DR. TOM A CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 SEA MOUNTAIN HIGWAY, SUITE C, LITTLE RIVER, SC 29566
(843) 399-4848
(910) 653-2346
Mailing address
AGAPE SENIOR PRIMARY CARE INC DBA MAIN STREET PHYSICIAN, 1624 MAIN STREET, COLUMBIA, SC 29201-2818
(803) 726-2350
(803) 753-9102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18363
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0248H
NC BCBS
NC
01
—
02787
NC BCBS
NC
01
—
0363
CIGNA MEDICARE
NC
01
—
080076269
RAILROAD MEDICARE
NC
01
—
2315069
CIGNA MEDICARE
NC
01
—
4770
SC MEDICARE
SC
01
—
561243962
BCBS
SC
01
—
561833405
SC BCBS
SC
01
—
570941629
BCBS
SC
05
—
5950176
—
NC
05
—
5950653
—
NC
05
—
E03PA0
—
SC
05
—
GP1062
—
SC
05
—
NPA648
—
SC
Enumeration date
07/07/2005
Last updated
04/30/2018
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