Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 43906 | MN |
NPI | 1033113063 |
---|---|
Provider Name | Gerald H. Dove |
First Address | Minneapolis, MN 55407-1320 |
Second Address | Minneapolis, MN 55407-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 21/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
303683900 | (05) | MN |
H47895 | (02) |