Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | LP1599 | MN |
Y | 103T00000X | Psychologist | LP1599 | MN |
NPI | 1013089937 |
---|---|
Provider Name | Mr. Robert A Hinman |
First Address | Moorhead, MN 56560-5055 |
Second Address | Moorhead, MN 56560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 29/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136502 | UCARE (01) | MN |
162853400 | (05) | MN |
3041602 | BHP/ PREFERRED ONE (01) | MN |
62-52391 | MEDICA (01) | MN |
9D635CO | BCBS (01) | MN |
HP19163 | HEALTHPARTNERS (01) | MN |