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General NPI Number Information
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NPI Number | 1598178733
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Entity Type | Organization
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Legal Business Name | MINNESOTA ONCOLOGY HEMATOLOGY PA
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 110105 PIONEER TRL W SUITE 302
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City | CHASKA
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State | MN
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Zip | 55318-2680
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Country | US
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Telephone | 952-928-2900
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Fax | 952-928-2944
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Provider Business Mailing Address
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Address Line | 110105 PIONEER TRL W SUITE 302
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City | CHASKA
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State | MN
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Zip | 55318-2680
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Country | US
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Telephone | 952-928-2900
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Fax | 952-928-2944
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEAN GESME
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Credential | MD
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Telephone | 651-602-5375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1076
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | 1076
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1076
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 1076
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 1076
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License Number State | MN
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Taxonomy #6
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 1076
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License Number State | MN
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Taxonomy #7
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1076
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License Number State | MN
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Taxonomy #8
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1076
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License Number State | MN
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1076
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License Number State | MN
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Taxonomy #10
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 1076
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License Number State | MN
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Taxonomy #11
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 1076
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License Number State | MN
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