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General NPI Number Information
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NPI Number | 1689641771
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Entity Type | Individual
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Provider Name | DOUGLAS N HOTVEDT MD
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Gender | Male
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 8600 NICOLLET AVE S - MAIL STOP 31500A HEALTHPARTNERS BLOOMINGTON CLINIC
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City | BLOOMINGTON
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State | MN
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Zip | 55440-1309
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Country | US
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Telephone | 952-541-2800
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Fax | 952-886-7015
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MS21110Q
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City | MINNEAPOLIS
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone | 952-883-5375
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Fax | 952-886-7015
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 33778
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License Number State | MN
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