Individual
DIJANA TALIC CHRISTIANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
128 MEDICAL PARK RD STE 101, MOORESVILLE, NC 28117-8579
(704) 658-1001
(704) 658-1002
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
(704) 658-1001
(704) 658-1002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012-01148
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920668
—
NC
Enumeration date
06/25/2010
Last updated
04/24/2018
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