Individual
DR. BRIAN WADE CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 MADISON PROFESSIONAL PARK, REXBURG, ID 83440-2058
(208) 656-9008
(208) 656-0999
Mailing address
20 MADISON PROFESSIONAL PARK, REXBURG, ID 83440-2058
(208) 656-9008
(208) 656-0999
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7414
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004529
BLUE CROSS
ID
01
—
DT307
BLUE SHIELD
ID
Enumeration date
02/21/2007
Last updated
07/09/2007
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