Healthcare Provider Details

I. General information

NPI: 1770506784
Provider Name (Legal Business Name): WHITNEY D TOPE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 FRANCE AVE S STE 564
EDINA MN
55435-2125
US

IV. Provider business mailing address

6545 FRANCE AVE S STE 564
EDINA MN
55435-2125
US

V. Phone/Fax

Practice location:
  • Phone: 952-746-6090
  • Fax: 952-224-1204
Mailing address:
  • Phone: 218-293-0120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number38930
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: