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NPI Code Detail

MEDICARE: PAUL F HOLTEN DO

MEDICARE: PAUL F HOLTEN DO
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
1207R00000XInternal Medicine Physician34319MN

Other Identifiers

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

General Provider Information

NPI Number : 1215909494
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL F HOLTEN DO
Provider Business Mailing Address
First Line : 6845 LEE AVE N
Second Line : MS21110Q
City : BROOKLYN CENTER
State : MN
Zip : 55429-1717
Country : US
Telephone Number : 763-503-4400
Fax Number : 763-569-0311
Provider Business Practice Location Address
First Line : 6845 LEE AVE N
Second Line : MS 31400A HEALTHPARTNERS BROOKLYN CENTER CLINIC
City : BROOKLYN CENTER
State : MN
Zip : 55429-1717
Country : US
Telephone Number : 763-569-4400
Fax Number : 763-569-0311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 04/11/2014

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Directions to “ PAUL F HOLTEN DO” Practice Location

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