Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 61966 | MN |
Y | 2080P0214X | Pediatric Pulmonologist | 61966 | MN |
NPI | 1649690355 |
---|---|
Provider Name | Daniel Beisang |
First Address | Minneapolis, MN 55404-4387 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 10/07/2020 |