Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 235980-1 | NY |
N | 208600000X | Surgeon | 235980-1 | NY |
N | 208200000X | Surgeon | 41916 | MN |
N | 208600000X | Surgeon | 41916 | MN |
N | 2086S0120X | Pediatric Surgery | 235980-1 | NY |
Y | 2086S0120X | Pediatric Surgery | 41916 | MN |
NPI | 1376668251 |
---|---|
Provider Name | Dr. Donavon John Hess |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 14/05/2012 |