Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 32868 | MN |
Y | 207VX0000X | Obstetrician | 32868 | MN |
N | 207VX0000X | Obstetrician | 34055020 | WI |
NPI | 1437142924 |
---|---|
Provider Name | Kevin A Hallman |
First Address | St. Paul, MN 55102-1225 |
Second Address | Woodbury, MN 55125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 31/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32868 | MN LICENSE (01) | MN |
34055 | WI LICENSE (01) | WI |