Individual
GARY CHRISTIANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2820 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-5462
(605) 342-3280
(605) 348-0662
Mailing address
2820 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-5462
(605) 342-3280
(605) 721-8458
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4012
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004134
BLUE CROSS BLUE SHIELD
SD
05
—
111516200
—
WY
01
—
21395
SANFORD HEALTH
SD
01
—
310365
BLUE CROSS BLUE SHIELD
WY
01
—
4012
DAKOTACARE
SD
05
—
7500340
—
SD
01
—
S4134
SD MEDICARE
SD
Enumeration date
08/30/2006
Last updated
05/18/2012
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