Healthcare Provider Details
I. General information
NPI: 1396778403
Provider Name (Legal Business Name): THOMAS DAVID HURWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2312 S 6TH ST STE F256
MINNEAPOLIS MN
55454-1336
US
IV. Provider business mailing address
2312 S 6TH ST STE F256
MINNEAPOLIS MN
55454-1336
US
V. Phone/Fax
- Phone: 612-273-8700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 20235 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | 20235 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: