Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 56806 | MN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35.099051 | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 45459 | KY |
NPI | 1043499577 |
---|---|
Provider Name | Hans Carl Bengtson |
First Address | Woodbury, MN 55125-4925 |
Second Address | Faribault, MN 55021-2935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2007 |
Last Update Date | 15/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043499577 | (05) | MN |
1043499577 | AMERICA'S PPO (01) | MN |
1043499577 | BCBS OF MN (01) | MN |
1043499577 | HEALTHPARTNERS (01) | MN |
1043499577 | HUMANA (01) | MN |
1043499577 | MEDICA/SELECT CARE (01) | MN |
1043499577 | MMSI (01) | MN |
1043499577 | PRIMEWEST (01) | MN |
1043499577 | TRPN (01) | MN |
1043499577 | UCARE (01) | MN |
56806 | MINNESOTA MEDICAL LICENSE (01) | MN |