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1174513659

NPI Code Detail

MEDICARE: DR. ANDREW EDWARD DORWART MD

MEDICARE: DR. ANDREW EDWARD DORWART MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	41640	WI
2	207R00000X	Internal Medicine Physician	33750	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174513659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW EDWARD DORWART MD

Provider Business Mailing Address
First Line	:	8170 33RD AVE S # MS 21110Q
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55425-4516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 CURVE CREST BLVD W
Second Line	:
City	:	STILLWATER
State	:	MN
Zip	:	55082-6040
Country	:	US
Telephone Number	:	651-439-1234
Fax Number	:	651-275-3325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	03/16/2021

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Directions to “ DR. ANDREW EDWARD DORWART MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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