Healthcare Provider Details

I. General information

NPI: 1457800393
Provider Name (Legal Business Name): MEDICAL LEGAL PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 10/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 COUNTY ROAD UU UNIT 3
HUDSON WI
54016-6602
US

IV. Provider business mailing address

PO BOX 251505
WOODBURY MN
55125-6505
US

V. Phone/Fax

Practice location:
  • Phone: 612-670-4971
  • Fax:
Mailing address:
  • Phone: 612-670-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT ERIC HANSON
Title or Position: CEO
Credential:
Phone: 612-432-4131