Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | D08901 | MN |
NPI | 1033282603 |
---|---|
Provider Name | James Edward Hinrichs |
First Address | Minneapolis, MN 55455-0357 |
Second Address | Minneapolis, MN 55455-0356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 14/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V02163 | (02) | MN |