Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 32853 | MN |
NPI | 1063481190 |
---|---|
Provider Name | Thomas P Ducker |
First Address | Saint Paul, MN 55102-2401 |
Second Address | Saint Paul, MN 55102-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 20/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010066 | PREFERREDONE (01) | MN |
101255 | UCARE MN (01) | MN |
23304 | AMERICA'S PPO (01) | MN |
31845600 | (05) | WI |
3600781 | MEDICA (01) | MN |
753708500 | (05) | MN |
8T417DU | BLUE CROSS BLUE SHIELD MN (01) | MN |
E57673 | (02) | MN |
HP13195 | HEALTHPARTNERS (01) | MN |