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NPI Code Detail

MEDICARE: DR. SIGNE DYSKEN M.D.

MEDICARE:  DR. SIGNE  DYSKEN  M.D.
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
12084P0800XPsychiatry Physician28125MN
22084P0805XGeriatric Psychiatry Physician28125MN

General Provider Information

NPI Number : 1457437741
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIGNE DYSKEN M.D.
Provider Business Mailing Address
First Line : 4500 PARK GLEN RD
Second Line : SUITE 360
City : ST LOUIS PARK
State : MN
Zip : 55416-4871
Country : US
Telephone Number : 612-822-2111
Fax Number :
Provider Business Practice Location Address
First Line : 4500 PARK GLEN RD
Second Line : SUITE 360
City : ST LOUIS PARK
State : MN
Zip : 55416-4871
Country : US
Telephone Number : 612-822-2111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2006
Last Update Date : 07/15/2007

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Directions to “ DR. SIGNE DYSKEN M.D.” Practice Location

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