Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 47356 | MN |
NPI | 1679545842 |
---|---|
Provider Name | Koken Ozdogan |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Paul, MN 55101-2502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 12/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
71711700D | (05) | MN |
I41102 | (02) |