Healthcare Provider Details

I. General information

NPI: 1851527709
Provider Name (Legal Business Name): LUKE THOMAS HAWES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

IV. Provider business mailing address

420 DELAWARE ST SE MAYO MAIL CODE 195
MINNEAPOLIS MN
55455-0341
US

V. Phone/Fax

Practice location:
  • Phone: 763-581-3700
  • Fax: 763-581-3701
Mailing address:
  • Phone: 612-625-1400
  • Fax: 612-625-4411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number58944
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: