Individual
DAVID M. CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 NW 16TH ST STE 205, FRUITLAND, ID 83619-2265
(208) 452-8100
(208) 452-8111
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-9086
ID
207XS0117X
Orthopaedic Surgery of the Spine Physician
M-9086
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010148683
BLUE SHIELD
ID
01
—
71753
BLUE CROSS
ID
05
—
807012400
—
ID
01
—
P00190924
RR MEDICARE
ID
Enumeration date
06/14/2006
Last updated
09/06/2024
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