Individual
CHARLES CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3701 PORT AUSTIN RD, PORT AUSTIN, MI 48467-9614
(989) 447-0309
Mailing address
3701 PORT AUSTIN RD, PORT AUSTIN, MI 48467-9614
(989) 447-0309
(989) 447-0310
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101015749
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518994011
—
MI
05
—
1518994011
—
MT
01
—
95906
BCBS
MT
Enumeration date
06/28/2006
Last updated
12/31/2024
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