Healthcare Provider Details

I. General information

NPI: 1306999370
Provider Name (Legal Business Name): STUART EDWIN HAUSER CAMERON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE HCMC-PL PATHOLOGY
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

701 PARK AVE HCMC-PL PATHOLOGY
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-6026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number48433
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number48433
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: