Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 19709 | MN |
NPI | 1093797763 |
---|---|
Provider Name | David L Hanson |
First Address | Saint Cloud, MN 56303-2735 |
Second Address | Saint Cloud, MN 56303-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0420027 | MEDICA HEALTH PLANS (01) | |
110901 | U CARE (01) | |
2114124 | FIRST HEALTH PLAN (01) | |
598529 | ARAZ GROUP AMERICAS PPO (01) | |
6D066HA | BLUE CROSS BLUE SHIELD (01) | |
986011 | PREFERRED ONE (01) | |
COMP | CHAMPUS (01) | |
COMP | MMSI (01) | |
COMP | ONE HEALTH PLAN GREAT WES (01) | |
D75685 | (02) | |
HP22741 | HEALTH PARTNERS (01) |