Healthcare Provider Details

I. General information

NPI: 1598851198
Provider Name (Legal Business Name): DOUGLAS YEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100 424 HARVARD STREET SE
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE ST SE MMC 292
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-625-5411
  • Fax:
Mailing address:
  • Phone: 612-625-5411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number41547
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: