Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 58587 | MN |
NPI | 1508209842 |
---|---|
Provider Name | Alexander Matthew Hubbell |
First Address | Minneapolis, MN 55454-1438 |
Second Address | Minneapolis, MN 55454-1438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 19/08/2019 |