Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 40006 | MN |
NPI | 1154384071 |
---|---|
Provider Name | Dr. Douglas David Hodgkin |
First Address | Minneapolis, MN 55425-4516 |
Second Address | Saint Paul, MN 55101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 31/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
959814600 | (05) | MN |
G56289 | (02) | MN |