Christenson, Wayne A

Christenson, Wayne A is an sole proprietor health care provider with primary practice located at 1485 M 139 , Benton Harbor MI 49022-5711. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Christenson, Wayne A can be contacted via phone (269) 925-0585.

Contact Information

Primary practice address
1485 M 139 Benton Harbor MI 49022-5711
Phone: (269) 925-0585
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01039706A Indiana
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01039706A Indiana

Profile Details

NPI number 1750324711
LBN Legal business name Christenson, Wayne A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Oct 20th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750324711 NPPES
Indiana Other 000000203802 ANTHEM
Indiana MEDICAID 100382510 ANTHEM

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