Individual
DR. CHRISTOPHER G KALLENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8900
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01066294
IN
2085R0202X
Diagnostic Radiology Physician
Primary
11489
ND
2085R0202X
Diagnostic Radiology Physician
4031084280
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200944030
—
IN
01
—
P00764117
RAILROAD MEDICARE
IN
Enumeration date
07/26/2007
Last updated
07/29/2025
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