Healthcare Provider Details

I. General information

NPI: 1912932922
Provider Name (Legal Business Name): CALVIN CARDIN LOKEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E SUPERIOR ST
DULUTH MN
55802-2238
US

IV. Provider business mailing address

5910 BERGQUIST RD
DULUTH MN
55804-8622
US

V. Phone/Fax

Practice location:
  • Phone: 218-722-3700
  • Fax: 218-722-8705
Mailing address:
  • Phone: 218-525-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number23268
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: