Christenson, Randall M
Christenson, Randall M is an individual health care provider with primary practice located at 1403 60Th St Se , Kentwood MI 49508-7065. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Christenson, Randall M can be contacted via phone (616) 719-4488.Contact Information
Primary practice address
1403 60Th St Se
Kentwood MI 49508-7065
Phone: (616) 719-4488
Fax: (616) 719-4480
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | 4301045911 | Michigan |
Profile Details
| NPI number | 1144253642 |
|---|---|
| LBN Legal business name | Christenson, Randall M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2006 |
| Last updated | Jun 24th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144253642 | NPPES |
| Michigan | MEDICAID | 103371307 | |
| Michigan | Other | 260D110830 | |
| Michigan | Other | 380001205 |
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