Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 37199 | IA |
N | 111NI0900X | Internist | 37199 | IA |
N | 207R00000X | Internist | 45995 | MN |
N | 111NI0900X | Internist | 45995 | MN |
N | 207RH0003X | Hematology & Oncology | 37199 | IA |
N | 207RH0003X | Hematology & Oncology | 45995 | MN |
N | 207RH0003X | Hematology & Oncology | 46666 | AZ |
Y | 207RX0202X | Medical Oncology | 45995 | MN |
NPI | 1083684187 |
---|---|
Provider Name | Dr. Thorvardur R Halfdanarson |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 14/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H84673 | (02) |