Provider Demographics
NPI:1265695589
Name:CHRISTIANSEN, DANIEL LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LAWRENCE
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7111 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2231
Mailing Address - Country:US
Mailing Address - Phone:913-901-5001
Mailing Address - Fax:
Practice Address - Street 1:2351 STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-6333
Practice Address - Country:US
Practice Address - Phone:920-651-8855
Practice Address - Fax:920-385-0287
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5609207ND0101X
WI13825207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery