Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G47190 | CA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G47190 | CA |
NPI | 1114973328 |
---|---|
Provider Name | Dr. Daniel V Landers |
First Address | Minneapolis, MN 55414 |
Second Address | Minneapolis, MN 55454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 01/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G471900 | (05) | CA |
675090700 | (05) | MN |
A95694 | (02) |