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General NPI Number Information
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NPI Number | 1578668174
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Entity Type | Individual
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Provider Name | KATHRYN E DUSENBERY MD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 500 HARVARD ST SE UNIVERSITY OF MINNESOTA PHYSICIANS
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-273-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 420 DELAWARE ST SE MMC 494 MMUNIVERSITY OF MINNESOTA PHYSICIANS
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-273-6700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 29219
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 29219
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 29219
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License Number State | MN
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