Healthcare Provider Details

I. General information

NPI: 1760540587
Provider Name (Legal Business Name): TODD MICHAEL HESS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 SMITH AVE N SUITE # 600
SAINT PAUL MN
55102-2424
US

IV. Provider business mailing address

280 SMITH AVE N SUITE # 600
SAINT PAUL MN
55102-2424
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-7572
  • Fax: 651-241-7272
Mailing address:
  • Phone: 651-241-7572
  • Fax: 651-241-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number30934
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: