Individual
DR. MARK DAVID CHRISTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 NW 16TH ST STE 102, FRUITLAND, ID 83619-2265
(208) 452-8015
(208) 452-8055
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 452-8015
(208) 452-8055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M11489
ID
207R00000X
Internal Medicine Physician
MD156651
OR
Other
Enumeration date
08/29/2006
Last updated
11/28/2016
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